CIS Participant Application
Student Application Deadlines:

• Kelowna - Tuesday, Sept 20.
Must be available for training on either: Friday, Sept 23 or Friday, Oct 14.

• Victoria - Monday, Sept 26.
Must be available for training on Friday, Sept 30, 4-7pm.

• Metro Vancouver - Monday, Sept 26
Must be available for training on one of:
- Wednesday,, Sept 28, 6-9pm.
- Sunday, October 2nd, noon-3pm.
- Tuesday, October 4th, 5-8/6-9 TBA.

• Abbotsford - Monday, October 3rd
Must be available for training on Wednesday, October 5th, 6-9pm.

Full Name (first & last)
Your answer
Company/School
Your answer
Position/Year & Program (2016-2017)
Your answer
Cell Phone #
Your answer
Work/Home Phone #
Your answer
Email
Your answer
Address (including postal code)
Your answer
Emergency Contact (name & phone)
Your answer
Student requirement: please fill in (you MUST be able to fulfill all 4 requirements!)
Mentor requirement: please fill in (you MUST be able to fulfill both requirements!)
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