Mentor Request Form
Fill in this form if you want to request a mentor to help you.|
Full Name: (REQUIRED) |
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Student Number: (REQUIRED) |
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College/Program: (REQUIRED) |
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| Accessibility Services Advisor: (REQUIRED) |
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| Courses you are taking or intending to take: (REQUIRED) |
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| Telephone Number: |
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| Email address: (REQUIRED) |
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| I would like to work with a peer mentor because I am hoping to...: (REQUIRED) |
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Describe any previous mentoring/tutoring/coaching experiences you've had either as a mentor or mentee, student etc.: (REQUIRED) |
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| My biggest worry for this year is...: (REQUIRED) |
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| One of my main goals for this year is...: (REQUIRED) |
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| Do you have any preferences for your mentor? (e.g., gender, age, whether or not they have a disability). Please describe: (REQUIRED) |
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| Describe your comfort level working, volunteering or studying with people from other cultural backgrounds than your own: (REQUIRED) |
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| Please indicate your availability to meet with a mentor during the week (Monday to Sunday): (REQUIRED) |
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| Verification code:(REQUIRED) |
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