AME 2019 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 by the end of February.

Application Deadline: February 15, 2019

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 Roxanne Finnie AME Manager, Member Relations at 604.630.3927 or rfinnie@amebc.ca

Personal Information

First Name*

Last Name*

Are you a 2019 AME Member?*

Email*

Phone*

Address

City

Province

Postal Code

Country

Current Occupation*

LinkedIn (Optional)

Education
Please tell us about your most recent degree:

School Name*

Degree and Program*

Graduation Date (actual or estimated)*

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

Short Bio (max 150 words):*

Professional Area of Interest*

What are your career goals?*
Max 100 words

Why are you pursuing this mentorship program?*
Max 100 words

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

Max 100 words

Finish this Sentence:*
"My ideal mentor would be...."

Max 100 words

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

How did you hear about this program?*

Are you permitted to work in Canada?*
You are:

Please upload a copy of your resume*

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

Email address