BCITSA MENTOR INTAKE FORM The BCIT Student Association 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. Please fill out and return this application to the BCIT Student Association: servicesmgr@bcitsa.ca, Fax: 604-434-3809. Personal Information: Name: Address: Preferred Method of Contact:
Email: Phone: How did you hear about this program?
Career Information 1. Employed at: 2. Job Title: 3. Please describe your field and area of specialty: 4. Years working in current field: 5. Please describe your work environment (e.g. clinic, lab, office, academic, etc.): 6. Do you interact with other fields? If so, which fields? Education Information 1. What program did you graduated from? 2. Do you have additional education, training and/or previous work experience? 3. Are you a BCIT Alumni? If so, what year did you graduate? Mentorship Information 1. What do you hope to gain from the Mentorship Program? 2. Do you speak a language other than English? If yes, what language? 3. Would you be willing to be included in our professional contacts database, from which we draw Speakers for Leadership presentations to our students? 4. Have you been a mentor before? 5. Is there any other additional information you would like to share that will help us in the matching process 6. What are your preferences regarding a match? (such as the mentees background, interests, personality etc. that would assist us in identifying a compatible mentee) 7. Mentees sometimes want to learn specific skills form their mentor. Please indicate the skills that you would be interested in helping a mentee with: Time management Leadership Networking Mock Interviewing Career/Life balance Transitioning to the career world Problem Solving Other: _____________________ Please attach a short biography about yourself. This information will be given to your match prior to both of you meeting.
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