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1. First and Last Name: (Required.)

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2. Which province are you currently residing/ arriving in? (Required.)

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3. What is your mentor's name? (Required.)

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7. Any specific comments/ feedback to your mentor? (Required.)

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8. Would you like us to share your feedback with your mentor? (Required.)

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9. My mentor helped me: (Please select as many options as applicable) (Required.)

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10. Have you and your mentor agreed to stay in touch? (Required.)

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11. Do you have any additional recommendations for the mentoring program? (Required.)

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12. Would you like to share a quote about the program? (Will be used in program outreach): (Required.)

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13. Are you interested in becoming a Canada InfoNet mentor after 2 years of work experience in Canada? (Required.)

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