CPRS Edmonton's Mentorship Program (Protégé Application Form)
Please answer all questions the listed below to be considered for the CPRS Edmonton Mentorship Program. Incomplete applications will not be considered. The deadline for applications is October 20, 2018.

Upon submitting your application, you will receive a confirmation email within one week. Should you not hear from us within this period, please contact both CPRS Edmonton's Mentorship and Education Co-Chairs, Marjorie Henderson at marjorie.c.henderson@gmail.com and Mikiko Van Horn at mikikovhorn@gmail.com.

The information collected in this form will be used to match you with a mentor and later shared with your mentor. All successful candidates are notified of their matches by email by the middle of Novembe 2018, and formal matches will commence in December 2018.

If you have any questions about the program please kindly email mentorship@cprsedmonton.ca.

Email address *
Name *
First and last name
Your answer
Birthday *
Which best describes your current gender identity? *
Your answer
CPRS membership number:
Your answer
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