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* 1. Title

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* 2. First Name

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* 3. Last Name

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* 4. Role

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* 5. University

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* 6. Email

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* 7. Will you be affiliated with your university for the next 12 months?

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* 8. Disciplinary background

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* 9. Short bio (100 words)

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* 10. What areas can you provide mentoring in?

This information will be used to connect mentors and mentees.

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* 11. For applicants not currently in a Pro Vice-Chancellor, Executive Dean or Dean role, please briefly describe the relevant experience and area of expertise you bring to the mentoring program.

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* 12. How many mentees could you take on in the 2025 program? (July to December with commitment of four one-hour meetings with each mentee)

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* 13. Is there anything else you would like to include to assist us in connecting you to a mentee?

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