Mentor Application

The following contact and employment information (if applicable) will be shared with your student.

The Cmolik Foundation hopes that the student and mentor will engage in a mentoring relationship that will last throughout the student’s undergraduate studies.

Mentors are asked to make a five-year commitment so that the student has a consistent mentoring presence during their education; someone they can lean on during difficult times and with whom they can celebrate their successes. The student/mentor relationship is reviewed annually to ensure the student/mentor relationship is a fit.

Part A: Introduction

1. Personal Information

Your Full Name

Address

City

Province

Postal Code

Contact Number

Email Address

Please upload your photograph (png, jpeg, jpg, gif)

2. How did you hear about The Cmolik Foundation Scholarship Program?

3. Who recommended that you become a mentor?

4. Why do you want to be a mentor and what do you hope to gain from the mentoring relationship? (character limit 250 or less)

0 / 250

5. Briefly describe what volunteer, vocational or life experiences you possess that may benefit the mentor/student relationship. For example, understanding workplace culture, confidence building, or helping students to identify employment and training opportunities. (character limit 250 or less)

0 / 250

Part B: Educational Background

6. Please list any certificates, diplomas, degree’s, designations and/or other professional accomplishments. (character limit 250 or less)

0 / 250

Part C: Employment Information

7. To assist in matching, please tell us a little about your career, past or present, positions held and specific sector experience. (character limit 250 or less)

0 / 250

Part D: Hobbies and Personal Interests

8. Tell us a little more about yourself, including hobbies, activities and personal interests. (character limit 250 or less)

0 / 250

9. Tell us about any associations or clubs you belong to that might be of interest to the student. (character limit 250 or less)

0 / 250

Part E: Agreement

By completing this form, and forwarding to TCF:

I agree to and understand the principles by which the mentorship program operates.
I understand that placement with a mentor or the pairing with a student will depend on the availability of volunteers and suitable candidates.
I agree to keep confidential the contact details of the student assigned to me and I agree not to use the contact information for any purpose other than to foster the mentorship relationship.

Enter your name to sign.