Menu

Mentor Application

Gender


Preferred Language of Communication (check all that apply)


(e.g. interests, volunteering, etc.)
Mentee Location (select all that apply)



Number of mentees


CONSENT
I understand that as a participant, I may be asked to provide feedback about the Mentoring program for the purpose of evaluation and improvement. I understand that my name will not be used in the evaluation report.

I understand that during the course of or at the end of the program I may be asked to provide feedback about my experience which may be used to promote the program. I understand that my name will not be used unless I authorize PDAC to do so.