I need a Mentor

Name(*)

Please type your full name.

Phone:

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Email:(*)

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Preferred method of contact:

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Community: (*)

Truro & Colchester County
New Glasgow & Pictou County
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Education & Employment

What is the highest level of education you have completed?

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Have you ever left a high school, postsecondary or employment training program prior to completion?

Yes
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If yes, why?

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Are you currently employed?

Yes
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If Yes, what type of employment?

Full Time
Part Time
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Do you have any volunteer experience?

Yes
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If yes, please describe:

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Is there a particular career field(s) that interests you and why?

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About You

What are some of your short-term goals?

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What are some of your long- term goals?

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What do you feel is preventing you from achieving these goals?

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What does success look like for you?

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How do you feel you could benefit from a retired persons skills/knowledge?

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Would you like to receive updates and information regarding Mentoring Plus Programming in your area?

Yes
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Date:(*)

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Signature of Mentor: (*)

Sign Above

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Click the checkbox to prove you are not a robot.(*)

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Individual Profile Form

Education & Employment

About You