Mentor Application Form

This program is designed for immigrants who live in rural communities in Alberta who are looking for a mentor with a goal to improve their workplace communication and improve their integration in their profession and community. This program aims to pair a mentor with a mentee (immigrant) who live in the same rural community

This application form is used to screen mentor applicants and will help us decide who is accepted into the program as a mentor, so please fill it out carefully and completely.

All information is collected and managed in compliance with the Freedom of Information and Protection of Privacy Act (FOIP). Your information is protected using both server authentication and data encryption, ensuring that your information is safe, secure and private. Your information will only be used for the purposes of this program.

Personal Information

First Name

Last Name

Date of Birth

Gender

Mailing Address

Town

Province

Postal Code

Phone Number

Email Address

Education Information

What is the highest degree or level of education you have completed?

Specify the degree/certificate obtained

Current Occupation/Career specialization

Professional certifications, designations (if any)

In which professional areas could you mentor? Specify the industries and occupations, and your related major activities and specializations. If you do not have a specific professional area or occupation in which you can mentor, please indicate what your ties to the community are and how they will help you in your mentoring role.

How many years of experience do you have in Canada?

How many years of experience do you have abroad? (Where?)

Additional Information

1. Why are you interested in this mentoring position?

2. Describe your previous experience with mentoring.

3. What are your expectations of this mentoring commitment?

4. What do diversity, inclusion and belonging mean to you?

5. Are you comfortable using a computer?

Not comfortable at all

Reasonably comfortable

Very comfortable

6. Are you comfortable using Microsoft Teams chat and video functions?

Not comfortable at all

Reasonably comfortable

Very comfortable

How did you find out about the Mentorship for Rural Immigrants program?

Please attach a copy of your resume with this application form (attachment), maximum allowed file size is 15M bytes

I attest to the truthfulness of all information listed on this application and agree to all the above terms and conditions.

The Province of Alberta is working in partnership with the Government of Canada to provide employment support programs and services