Mentor Questionnaire

If you have problems filling in this form or if you have questions, please contact:

Elizabeth Drouin
Alumni Coordinator
edrouin@cwy-jcm.org
1-800-605-3526 x 338


  1. First Name *

  2. Last Name *

  3. Street Address *

  4. Address Line 2

  5. City *

  6. Province

  7. Postal Code

  8. Country

  9. Phone *

  10. Email *

  11. Have you ever been involved with CWY in the past? If yes, please specify how and when. *

  1. Gender *
    If other, please specify:

  2. Language *
    If other, please specify:

  3. Please indicate the field(s) of practice in which you work or have previous experience (ex. environment, health, education, marketing, community development, law, etc.)

  1. What is your experience in a mentorship relationship? *
  2. Please describe why you chose to participate in this program and how your qualifications and expertise will contribute to your success as a mentor. *

Other comments

If you would like to let us know about any other information about your application, please let us know below.

  • How did you hear about the CWY Mentorship Program? *
    If other, please specify:

  • CV *

    We ask that all mentors and mentee include a copy of their current CV with their application to provide to their mentorship partners and to aid CWY in creating the best possible mentorship match. Please upload your .doc, .docx or .pdf file.

    Agreement *

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