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Mentorship Program Application
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Student ID
Your answer
Year of Study
*
1
2
3
4
5+
Gender
Male
Female
Clear selection
Email
*
Please leave the email you would like your group members to contact you with.
Your answer
Phone Number
*
Please leave the preferred number you would like your group members to contact you with.
Your answer
Preferred Contact Method
*
Email
Phone Call
Text Messages
Other:
Birthdate
*
MM
/
DD
/
YYYY
Position:
*
Mentor
Mentee
Major
*
Industrial Systems Engineering
Petroleum Systems Engineering
Environmental Systems Engineering
Software Systems Engineering
Electronics Systems Engineering
Time will tell!
Required
First Language
*
English
French
Other:
International Student
Yes
No
Clear selection
Ideal Group Members
Please list the names of anyone else in the program that you would like to work with.
Your answer
Comments or Suggestions
Your answer
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