AME 2020 Mentorship Program Mentor Application Form

Thank you for your interest in the AME Mentorship Program. We are excited to have you participate. All applications will be reviewed after the deadline and each applicant will be contacted as to the status of their application. Application Deadline: February 10, 2020 PLEASE NOTE: You cannot save and return to complete this form. You may want to review the questions in advance so that you leave enough time to complete the application form. If you have any questions please contact Stasia Wegner AME Manager, Member Services at 604.630.3930 or swegner@amebc.ca

Personal Information

First Name*

Last Name*

Are you a 2020 AME Member?*

Most Roundup passes come with a 2020 membership.

Select or enter value

Email*

Phone*

Address

City

Province

Postal Code

Country

Professional Information & Background

Please either upload an updated resume or provide a link to an updated LinkedIn profile.

Current Title*

Current Company*

Area of Expertise*

Short Bio (max 150 words):*

Linkedin Link

Please upload a copy of your resume

Drag and drop files here or

Mentorship Program Information

Please tell us about yourself and why you are interested in participating in the AME Mentorship Program

Please provide examples of recent volunteer work or how you have given back*

Max 100 words

Please provide a reference or example of someone you have mentored*

This does not have to be as part of a formal program Max 100 words

Finish this Sentence:*

"My ideal mentee would be...." Max 100 words

Gender Preference?

Do you have a gender preference for your mentee? If so, identify which gender you would prefer to be matched with.

How did you hear about this program?*

By submitting this application, I confirm that I am able to commit to the one-year AME Mentorship Program and that I will abide by the terms of the AME Mentorship Framework and the Mentor/Mentee Commitment Contract. Please check the box below to indicate your agreeement.

Committment Agreement*

All participants are required to be current members of AME. By checking the box below you confirm that you understand that this is a requirement of participation in the AME Mentorship Program. All memberships will be verified prior to an application being considered.

Membership Requirement Confirmation*

Send me a copy of my responses

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