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

Please tell us about your most recent degree:

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

Max 100 words

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:

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