C-SARN Mentor Application Form

Thank you for your interest in our Mentorship program. Please fill out the following question. It will help us find a possible match. We will ask you to upload your latest cv/resume as part of this application

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* 1. Your name

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* 2. Street Address

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* 3. City/Town

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* 4. Province/Territory

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* 5. Postal Code

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* 6. Phone

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* 7. Email Address

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* 8. CSARN mentors must be at least 60 years of age.  Please confirm that you qualify.

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* 9. Website

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* 10. In Which Artistic Discipline[s] do you work?

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* 11. If you have checked more than one discipline, please let us know in which area you would like to be a mentor

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* 12. How many years have you been practicing your art [does not have to be consecutive]?

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* 13. Please list your professional affiliations

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* 14. Please tell us what type[s] of mentorship would interest you.

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* 15. Why are you interested in being a mentor?

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* 16. Please describe briefly what you think makes a mentorship successful.

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* 17. Do you have experience as a mentor? If so, please describe the experience and whether you consider it a success.

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* 18. Please give us a brief description of your work and what you can teach a mentee. This is like an 'elevator pitch' and will be added to the Mentor Match page of our website [up to 100 words].

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* 19. Would you prefer to work with [please check all that apply]:

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* 20. Are you able and willing to work in a language other than English?

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* 21. Are you willing to travel to a different location as part of a mentorship?

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* 22. Would you allow us to share your information with a potential mentee?

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* 23. Please upload your latest cv or resume

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