2805MENTOR

Mentoring Registration Form

Complete your formal registration

You're about to join a community of professionals, from across the globe, who've leveraged PCiBS's personalized, people-mediated online degree courses to gain verifiable skills and stand out from the crowd.

* Required fields

* Photos / ID's can be picture format (5 MB max)

** Uploads of files must be in PDF format (5 MB max)

Please make sure that you fill in all required fields. Information not supplied might delay your enrollment process.

The allocated student number enables the business school (PCiBS) to keep all your information together. Always use your student number when corresponding the PCiBS Administration Department.

1. Complete enrollment for Mentoring.

2. Use the student number issued to you in your Mentoring form. Registration without a number will have delays.

3. Mentoring has NO registration fees.

For more information around enrollments and registration see Part 2 of the Terms and Conditions under the Application process.

PCiBS - Application Status*

New Student

Existing Student

Student Number:

Use the Student no. issued to you by PCiBS:

Passport sized Color Photo:*

The photos should be 45mm high and 35mm wide.

Part 1: Personal Details

Please note, your name must match your ID, passport or birth certificate.

Last name:*

First name(s) in Full:*

Initials:*

Nationality:*

No abbreviations

Salutation:*

Miss, Mrs, Ms, Mr, Dr

Date of Birth -YYYY-MM-DD:*

Use cursor DD, MM, YY to select:

Year/Month/Day

Mother Tongue / Home Language:*

Gender 02:

Your personal Identification No:*

If you have no ID use your passport number:

Passport or Gov. Identification:

Passport Number (Optional):

Part 2: Contact details

(+ country code) Mobile:*

(+ country code) Phone number:

Email:*

Mailing Address:

The address will be re-confirmed for delivery via mail or courier service* of any reports and certificates.

PO Box Number:

Street address:

City:*

State/Region:

Country of residence:*

Postal Code:

Part 3: Mentoring Program selection:

Programs must be paid as follows:

1. Once off

2. According to PCiBS Semester periods (upfront payment)

3. Monthly subscription for period of program selection (2 months upfront payment).

Note: Preference of number of sessions must be added. The final number of sessions will be finalized and confirmed during the 1st and 2nd session.

Mentoring sessions preference:

This selection will assist with planning the total number of sessions required.

Mentoring Starting Month:

Note: Two weeks are required for administrative functions.

PCiBS - Payment preference: *

Once off

Semester by Semester

Month by Month

Part 4: Highest Qualification & CV

Name of Qualification:

Name of University / College / Institution:

Updated CV or Resume:

Please supply us with a short motivation of what exactly you require us to assist you with in Mentoring.

Mentoring is a long-term process based on mutual trust and respect.
Mentoring over short period of time is not impossible, but is not very effective.

Select your program duration accordingly.

Written Mentoring motivation submission:

Select the number of Mentoring months you envisage:*

Part 5: Contacting methods:

Please use the following methods to contact me, besides the mailing address(es) above.