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Mentor Application Form

The main objective of the PEAK Enterprise and Innovation Programme’s Mentorship Programme is to help build a pro-bono mentorship programme for startups and MSMEs and further cultivate the business mentorship in the country. This form will help PEAK to build the database of mentors, develop the training programme for mentors and allocate the mentors to upcoming programmes.
We will ensure the confidentiality of received information and may share the results of this survey only with Programme’s international consortium partners and funder, UK aid.

    General Information

    1.First Name:*

    2.Last Name:*


    a. Maleb. Female


    5.Phone Number:*

    6.Location (City):

    7.Highest level of education:*


    8.LinkedIn URL




    a. Educationb. Food processing & Manufacturing of Food Productsc. Handicrafts & souvenirsd. Hotels, Restaurants and Cafes (HoReCa)e. ICT services (e.g. SaaS, agtech, clean-tech, e-commerce, edtech, foodtech, healthtech, fintech, and other industry verticals, etc.)f. Retail & E-commerceg. Textiles & Ready-to-wear Garments & accessoriesh. Tourism, leisure & Entertainmenti. Transportation, Storage & Logisticsj. Wholesale & Distributionk. Small scale productionl. Clean energyOther

    12.Do you have previous experience as a mentor?*

    a. Yesb. No

    13. If yes, please provide the name of the organisation/individual with brief description of your mentoring experience.

    14. Please, describe why you are interested in volunteering to be a mentor?*

    15. Which of these fit your description of interest in volunteering mentorship?*

    a. Personal interestb. Professional interestc. Educationd. Society developmente. PEAK Alumni

    16. What type of businesses companies (idea stage, startup, MSME) and business sector (e,g, trade, education, tourism, IT, e-commerce, agriculture, services) would you prefer to mentor?*

    Stage of development

    i. idea stage startupii. early stage startupiii. growth stage startupiv. established SMEs

    Economic sector / industry

    i. educationii. healthcareiii. tourismiv. ITv. financial servicesvi. e-commercevii. small productionviii. servicesix. agriculture

    17. Language proficiency

    a. English:

    i. no proficiencyii. elementaryiii. intermediateiv. advancedv. native

    b. Russian:

    i. no proficiencyii. elementaryiii. intermediateiv. advancedv. native

    b. Kyrgyz:

    i. no proficiencyii. elementaryiii. intermediateiv. advancedv. native

    18. Mentor Availability - The Mentorship Programme requires mentors to be available per the scheduled time between mentors and mentees. The Programme requires meeting with your mentee face-to-face, by phone or video and/or through email interaction for at least 4 hours per month.*

    a. I am able to allocate 4 hours per monthb. I am not able to allocate 4 hours per month

    19. Please provide any other information about yourself that you deem important but is not covered in this form.

    Thank you for submitting the form for PEAK Mentorship Programme..

    © PEAK, 2023

    © PEAK, 2023