Hello potential SIS Mentor! Please fill out all fields as required, or put a 0 or N/A in the text box.

Mentor Name *


Contact Email *

Contact Phone Number *

Street Address *

City of Residence *

Province *

Postal Code *

Please enter in format X1X 2Y2

Region *

Best Time to Call *

Please let us know the best times to contact you by phone, or write email only in the box.

Occupation

Employer/School/Professional Association *

Where you currently work, attend classes or are amemeber.

Degree or Certificate Possessed *

eg. BSc Physics, P.Eng

Previous Experience *

Briefly describe any previous experience you have working with children and why you would like to volunteer for this program.

I can speak to students about the topics above- please choose ALL that apply

Topic Comments *

Please include any details regarding the topics you have chosen, or any additional topics not listed above. Please give as much detail about each topic as possible (eg: Engineering-Civil, how to build bridges).

I Prefer to Present to Grades: *

Please check all that apply, we will match your preferences as closely as possible.

Presentation STYLE *

Please select ONE

I can travel for SIS sessions: *

Please check ALL that apply

Language *

Language(s) I can comfortably use for my SIS session.

When are you available to start visiting classes? *



In a school year ( September to June), I am able to do: *

Please choose ONE, and let us know in the Comments if there are other details we should know about your availability.

SIS Activation workshop *

Referral *

How did you hear about our program?

Reference 1 *


Reference 1 Email Address *

Reference 2 *


Reference 2 Email Address *

Important!
If after clicking Finish Survey, you are still on this page, most likely you have not filled out some information.
All fields are REQUIRED to be filled out.
If you do not have an answer for a particular field, please put a 0 or n/a.