IECBC Mentee Registration Form

IECBC Mentee Registration Form
We are committed to protecting your information and will not disclose it to any external party unless required by law or necessary to provide you with our program’s services. For more information about the program, please visit our website: www.iecbc.ca/mentorconnect. Completing the registration form typically takes 10 minutes.
Contact and Eligibility Information
Name*

First NameLast Name
Primary Email*
example@example.com
Where do you currently live?*
Where are you located in British Columbia?*
If you chose "Other", please specify the location in BC.
Do you intend to land and settle in British Columbia?*

YesNo
How long have you been in Canada? (If it’s less than a year, enter 0.5.)*
What is your current immigration status in Canada?*

General Information
Phone Number*
Please enter a valid phone number.
LinkedIn Profile Link*
What is your gender?*
How did you hear about the MentorConnect program?*
Which IEC-BC program referred you?*

ASCENDFASTTalentConnect
If you were referred by a partner organization, please specify. The organization may be a settlement service provider or an academic institution. If you are enrolling yourself, please choose 'Self-enrolled'.*
If you selected 'Other,' please enter the name of the service provider or the academic institution.*
Please specify which program you are accessing at ISSofBC.*
Who is the Employment Coach you are working with? Please provide their full name. Other terms for Employment Coach may include Career Strategist or Case Manager. Please note that your coach will support you as needed and will be copied on any communications sent to you.
Full name of your Employment Coach*
Email address of your Employment Coach*
example@example.com

A few last questions!
Which official languages do you speak?*

EnglishFrench
What is your preferred official language?*

EnglishFrench
Please indicate any languages you are fluent in apart from English.
Please specify the other language(s).
What is your CLB level for the English language?
What ethnicity or racial category do you identify with?*
What is your date of birth?*

MonthDayYear
Date
Are you currently receiving other settlement support services from a service-providing organization (e.g., ISSofBC, SUCCESS, Douglas College, Back in Motion)?This may include services such as social services, community connections, language classes, etc.*

YesNo
Would you like to stay informed and receive updates about other IEC-BC programs and events?*

YesNo
I understand that, as a mentee, I am expected to be proactive and take the lead in the partnership when matched.*

I agree
Would you like to provide any additional information?

Contact and Eligibility Information