Mentor Application Form

Name(*)
Please let us know your name.

Address
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Work phone
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Cell phone
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Other phone
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Email
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Company you represent
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Position held
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Work address
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Do you give permission for Ignite to contact your company to give you credit for your investment in the young adults of Ignite and a healthy society?
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If yes, who is the contact in your company for the purpose of acknowledgement?
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Is there anything that legally would prevent you from being involved with young people?
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Are you
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Have you been a mentor in the past?
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Are you comfortable mentoring
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Comments regarding your preference
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What special skills/ competencies/ passions do you possess that will make you a great mentor?
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  • © 2013 Ignite Adult Learning Corporation • All rights reserved. • www.ignite.ca • Updated 10.07.17.