Mentorship Program Enrollment Form

Mentorship Program Enrollment Form

Welcome to the enrolment form for College's Mentorship Program. This form will allow you to enrol in the program, either as a person who will mentor others on your committee or as a person who is seeking a mentor on a committee to which you have been appointed.

Remember, you can be a mentor on one committee and a mentee on another committee. There are no restrictions on the number of times you enrol.

To facilitate this, the form will reload for another entry once you submit your information.

First Name*

Please enter your first name.

Last Name*

Please enter your last name.

Registration Number

If you are registered with the College, please enter your registration number.

E-mail*

Please enter the email address you wish to use for this program. It does not need to be the same as the primary email address you use with the College.

Committee*

Please select the Committee for which this enrolment applies.

Select

Mentorship Role*

Please indicate the role you wish to play as it relates to this Committee.

Mentee

Mentor

Copy of Submission

Below is a check box to receive a copy of your submission. It is recommended that you check this box and enter your e-mail address for a second time. This will enable the on-line system to send you a copy of the information that you have provided to the College on this form.

Send me a copy of my responses

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