Username
*
E-mail
*
If you are in university please provide your university email
What city are you currently living in?
Mobile Number
*
Required phone number format: ###########
Password
*
Minimum length of 8 characters.
The password must have a minimum strength of Strong
Strength indicator
Repeat Password
*
Role
Mentor
Mentee
Member
Parent/Guardian Full Name
*
Parent/Guardian Email Address
*
Ethnicity
*
Black African
Black Caribbean
Black Caribbean and African
Black African and other ethnicity
Black Caribbean and other ethnicity
What year group are you currently in?
*
Year 11
Year 12
Year 13
Education Level
*
End of Year 13
Undergraduate
Graduate
Education Level (Member)
*
Year 12
Year 13
Undergraduate
Postgraduate
Full time Employment
Other
Which one of these newsletters would you like to subscribe to?
Medicine Newsletter
STEM Newsletter
Humanities Newsletter
Law Newsletter
Economics Newsletter
Apprenticeships Newsletter
Maths and Finance Newsletter
You will automatically be subscribed to our General Newsletter.
Which university are you attending/ did you attend?
*
What is/was the title of your course?
*
What is the name of the school you attended during GCSEs?
*
What A-levels/IB subjects do you take?
*
English, Maths, Further Maths
List your A Level subjects, separated by commas
What are your target/predicted A-level grades? (Leave blank if unknown) Your answer
English A*, Maths A, Further Maths A, etc
List your A Level subjects and expected grades, separated by commas
What are your achieved GCSE grades?
*
English A*, Maths A, Physics A, etc
List each GCSE module and grade separated by a comma.
What type of school do you attend?
*
Fee paying
Non-fee paying
What course(s) are you considering to study at university? (You may put the subject area if unsure e.g Humanities)
*
What universities are you considering applying to?
*
Durham, Bristol, Brunel
Input your list of universities, separated by commas
Have you been eligible for free school meals in the last 5 years?
*
Yes
No
Unsure
Rather not say
Personal statement
*
(Tell us about you as a person, your hobbies, interests, job etc)
What are your features that you think make you a good mentor?
*
What does Black Excellence mean to you?
*
What do you think you can offer to your mentee to help them excel?
*
What are your long term goals?
*
What do you want to gain from joining the Black Excellence Network?
*
How did you hear about us?
I, the mentee confirm that I have read and agree to the terms outlined below.
*
https://www.blackexcellencenetwork.net/privacy-policy/ https://www.blackexcellencenetwork.net/safeguarding-policy/
I, the mentor/member confirm that I have read and agree to the terms outlined below.
*
https://www.blackexcellencenetwork.net/privacy-policy/ https://www.blackexcellencenetwork.net/safeguarding-policy/
I, the parent/guardian of the mentee confirm that I have read and agree to the terms outlined above.
*
Send these credentials via email.