Application for Membership 2017

First Name / Initials
Surname
Address
Postcode
Email
Landline / Mobile
LinkedIn / Website

Business Experience Summary: (please give a summary of your business background and achievements 250 words maximum)

When did you start business mentoring? A minimum of two years is required

Mentoring Experience: please give a summary of your experience in mentoringfor individuals/companies/team. Include coaching if you feel appropriate however please differentiate between the two services.

Relevant qualifications with accredited body and dates –

There is a minimum requirement of one (full day) workshop or course

Current Association Memberships:

As part of the membership process we undertake background checks of the details you supply. Do you consent to this: Y/N?

Insurance details – PI insurance is a prerequisite for membership

Broker:
Professional Indemnity cover £
Public Liability cover £

Please highlight your areas of proven expertise:

Strategy / Funding
Marketing & PR / Legal
Operations / Change Management
Finance / Other
IT/Technology / Other
People & HR / Industry of preference
International Growth / Industry of preference

The aim of this association is to provide a regulatory body for business mentors to inspire confidence in the business owners seeking business mentoring. It will also provide regular news, training and seminars. By signing below you confirm that you have read and agree to the code of ethics

and necessary procedures of the Association of Business Mentors.

Signature ...... Date…………………..

How did you hear of the ABM?......

Nominating members:

Referees:It is a prerequisite to have worked with at least ten businesses over a minimum of two years

NameReferee Contact details

Do you use: / Terms and Conditions / Client Contract

Any requests or suggestions for Training, Benefits, topics for Professional Information Mornings or generally…

Payment details

ABM fees are

£50 one off joining/set up fee

£45per quarter via direct debit (no VAT) or a one off upfront payment of £150

Monies will be collected via our direct debit facility GoCardless details of which will be emailed to you once your application has been processed.

Please return your completed application

via:

  • Scanned and email to
  • Automatically with Docusign please request
  • Post to 73 Temple Sheen Road London SW147RS *Not the company registered address

Thank you

Office use only:

Initial Fee received References checked by
1 / Association of Business Mentors, 73 Temple Sheen Road, London SW147RS
Registered Address: The White House, 19 Ash Street, Ash GU12 6LD Registered Company Number 753326 Limited by guarantee. Not for profit.