Mentor Signup

All information will be kept strictly confidential and will be used for internal purposes only.

About You

First name

Last name

Gender

Male
Female

Home address

City

Postal code

Work Phone Number

Cell Phone Number

Alternate Phone Number

Email

Which is the best way to contact you?

About your education

Highest Level of Education attained

About your employment

Employer name

Employer Address

City and Province

Postal code

Job title

Short description of your duties

How long have you been working for your current employer?

Years

Months

About you as a mentor

What is your main industry experience?

If other, please specify.

What do you think is the area you can assist the mentee with most?

Have you attended any diversity training workshops?

If yes, where and when?

What professional background would you prefer your mentee to have?

Please list any Professional Association/Affiliations that you belong to

Confidentiality

Do you give ERIEC permission to share your professional background with your mentee before meeting him/her?

Do you give ERIEC permission to follow up with you post mentorship for the purposes of program quality assurance?

How did you hear about us? If other, let us know how.

By submitting this application, I certify that the information provided in this application is true and complete to the best of my knowledge. I realize and accept that the Edmonton Region Immigrant Employment Council will rely on this information as they undertake their review of my application for the Career Mentorship program.

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