Mentor intake form

BCIT Student Association Mentorship

Mentor Intake Form The BCIT Student Association (BCITSA) Mentorship program introduces students to a professional industry Mentor. Mentors provide students with guidance in successful business and academic strategies that will ensure success in the student’s future career.

Name: Email: Phone: Preferred Method of Contact:

Phone

Email

Employed at: Job Title: Please describe your field & area of specialty: Years working in current field: Please describe your work environment (e.g. clinic, lab, office, academic, etc.): Education: Are you a BCIT Alumni?

What do you hope to gain from the Mentorship Program?

Do you speak a language other than English in the workplace? If yes, what language?

3700 Willingdon Avenue, Burnaby BC, V5G 3H2 | Bus: 604.432.8600 Fax: 604.434.3809 | www.bcitsa.ca

Would you be willing to be included in our professional contacts database, from which we draw Speakers for Leadership presentations to our students?

Yes No

Have you been a mentor before?

Is there any other additional information you would like to share that will help us in the matching process?

How did you hear about this volunteer role? (Alumni email, BCIT Venture Center contact, etc.).

Return Intake forms to: Uconnect Resource Centre BCIT Student Association 3700 Willingdon Avenue, Burnaby, BC V5G 3H2 Bldg SE2, Rm 286 servicesmgr@bcitsa.ca or uconnect@bcitsa.ca (general office) 604.432.8549 or 604.451.7087 (general office) www.bcitsa.ca

3700 Willingdon Avenue, Burnaby BC, V5G 3H2 | Bus: 604.432.8600 Fax: 604.434.3809 | www.bcitsa.ca