2020-2021 PhysioMP Registration for [Undergraduate Mentors]
Please enter the form details below to become a mentor for new PSL undergraduates.

Due to COVID, mentorship interactions may be fully virtual depending on you and your mentee.
Email address *
UTOR ID (if you wish to receive CCR; https://physiomp.com/requirements-for-ccr/)
Student number (if you wish to receive CCR; https://physiomp.com/requirements-for-ccr/)
First Name *
Last Name *
Program (Physiology) *
Year of Study *
# of mentees you are willing to accept: *
What are you hoping to gain from this mentorship experience? Please select all that apply: *
Required
What are your experiences & specialties? Please select all that apply (in order to better match with mentees of similar interests): *
Required
Choose 3 to 5 of the following characteristics that others would describe you as: *
Required
Please select all that apply (in order to better match with mentees of similar background): *
Required
Would you be interested in the Learn2Run program for an additional CCR credit? https://physiomp.com/learn-to-run-program/ *
Additional comments that you would like to provide:
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