Mentee Application

Name

Phone

Street Address

City/Town

Province

Postal Code

Application Date

Website (optional)

https://

If you have listed more than one discipline, in which one would you like a mentor? (optional)

Please list any professional affiliations. (optional)

Why do you feel you need a mentor? What do you hope to gain from the mentorship?

How did you find out about us? (optional)

If you have looked through the Mentor Match section of our website, is there anyone you would like to work with? If so, please enter their number[s] here. (optional)

Sometimes our mentors and mentees live in different communities. Would you be comfortable with a mentorship that took place via an online technology such as Zoom?

Yes

Yes, with some guidance

Please upload your latest resume or CV.

Choose file

Uploading… (0%)

Browse

Oops. This file type isn’t allowed.

This file size is too big.