Mentor Application Form -- Kingston
Hello! Thank you for your interest in our program. Please complete the form and we will be in touch with you via e-mail shortly.

For any specific questions, please contact Christina Yan (Mentorship Coordinator) at christina.yan@queensu.ca or Kathryn Hong (Founder) at hong.k@queensu.ca

General inquiries: itsagirlsystem@gmail.com
Email address *
First and Last Name *
Your answer
Current Position/Title *
Your answer
Current Affiliation *
Your answer
Previous Affiliation
Your answer
Highest level of education completed
Your answer
What "fields of study" is your current/most recent role most closely related to?
How many years of experience do you have in your designated professional field? *
Do you have previous experience with supervision/mentorship? *
If you do have previous experience mentoring, please expand (under 200 words).
Your answer
Briefly outline the skills, experiences, or expertise you are interested in sharing with a mentee.
Your answer
When will you be available to mentor? *
I prefer to mentor through:
If there's anything you would like to tell us that would help us match you with a mentee, please do so here! This can be anything – personal or professional interests, preferences as to the age of your mentee, etc.
Your answer
What do you hope to gain as a STEM mentor?
Your answer
We have identified 6 specific areas of learning for mentor/mentee pairings. Please rate your preferences from 1 to 6 based on your knowledge and experience, 1 being most preferred.
Due to limitations of Google Forms, the next 6 questions will be your rankings. So you are able to decide beforehand, the areas of learning are:
1. Effectively managing the transition from high school to university/college
2. Looking for internship/work-study/volunteer opportunities
3. Developing and building strong workplace skills (resume writing, problem solving, negotiating, interviewing, time management, leadership)
4. Managing work/school-life balance
5. Brainstorming future avenues and career opportunities
6. Workplace shadowing
Effectively managing the transition from high school to university/college
Looking for internship/work-study/volunteer opportunities
Developing and building strong workplace skills (resume writing, problem solving, negotiating, interviewing, time management, leadership)
Managing work/school-life balance
Brainstorming future avenues and career opportunities
Workplace shadowing
Who else should we be talking to? In other words, if you have any contacts you think would be interested in our program (as a mentor, community partner, advisor, etc) please write their information here
Your answer
We ask that mentors commit at least 2 hours a month to mentorship. How much time would you be willing and able to put into our program?
What times would you be able to meet with your mentee?
Morning
Afternoon
Evening
Monday
Tuesday
Wednesday
Thursday
Friday
Weekend
How did you hear about our program?
I have recently completed a Criminal Record Check (this is a requirement to be a mentor)
If there's anything else you would like to add, please do so here!
Your answer
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