Become a Mentor Full Name Email Address Phone/WhatsApp Number Country of Residence Current Location (City & Country) Are you: A student A new immigrant Other (please specify) What stage are you currently in? Pre-departure (planning to study/move to Canada) Settling in Canada Already studying in Canada Working in Canada Other (please explain) What are your main goals for joining the mentorship program? (Choose all that apply) Academic guidance Settlement support Cultural adjustment support Career planning/career advice Networking & community support Confidence building Other (please specify) Please describe, in your own words, what challenges you hope mentorship will help you overcome: What type of mentor support are you looking for? One-on-one mentorship Group mentorship Short-term (1–3 months) Long-term (3+ months) How often would you like to meet with your mentor? Weekly Bi-weekly Monthly Other (please specify) What mode of communication do you prefer? Zoom/Video call Phone call Email Messaging/WhatsApp Other (please specify) What days/times are best for you? Highest level of education completed: High school Undergraduate degree Graduate degree (Master’s/PhD) Vocational/Professional certificate Other (please specify) Field of study or area of interest: What skills, interests, or strengths do you bring to the mentorship relationship? What are your top 3 goals or outcomes you want to achieve through this mentorship? Are you willing to commit time and effort to engage actively in the mentorship process? Yes No How did you hear about the D2R Mentorship Program? Social media Website Friend/Referral Email newsletter Other Signature (Sign and upload your signature and resume) I agree to participate respectfully and responsibly in the mentorship program: Yes, I agree Submit
