IECBC Mentor Registration Form

IECBC Mentor 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
Email*
example@example.com
Do you live in British Columbia?*

YesNo
How many years of professional experience do you have in your field in Canada?*

General Information
How many years have you lived in Canada?
Have you mentored with us before?*

YesNo
Has your information changed since you last filled out the mentor registration form?*

YesNo
Form filled by (admin use only):
Enter your name or ‘IEC-BC Admin Team’

General Information
Where in British Columbia are you located?*
If you chose "Other," please specify the location in BC.*
How did you hear about the MentorConnect program?*
If 'Other,' specify how you heard about MentorConnect.*
Are you part of a cohort?*
A cohort refers to a group of mentors from the same employer who join the mentorship program at the same time. Each mentor is still matched individually with a mentee. Please select ‘Yes’ if you are participating as part of such a group from your employer.
What is your LinkedIn profile link?*
What is your phone number?
Please enter a valid phone number.
What is your gender?*

Occupation and Industry

Please share your occupation and other relevant details to help us match you with the most suitable mentee.
What is the name of your employer or company?*
What is your job title?*
Which department or division do you work in?
What is the size of your company?*
Which occupations or job titles are you comfortable mentoring others in? Please separate your answers with a comma (,).*
Which industry best corresponds to your background and experience?*
For more information, refer to: Canadian Industry Statistics

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

EnglishFrench
Which is your preferred official language?*

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

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

YesNo
Would you like to provide any additional information?

Contact and Eligibility Information