AME 2020 Mentorship Program Mentee 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. 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

Select or enter value
Caret IconCaret symbol

Education

Please tell us about your most recent degree:

Mentorship Program Information

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

Max 100 words

How do you think participation in the mentoring program would contribute to your professional and/or academic development? Max 100 words

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

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

You are:

Select or enter value
Caret IconCaret symbol
Drag and drop files here or

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.

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.