The Virtual Education and Mentorship Program, offered through SickKids International Education, provides organizations and learners with customized online learning experiences designed to transform knowledge into practical expertise and enhance patient care.

To learn more about Virtual Education & Mentorship, please complete the online application form. Once we receive your application, a member of our team will contact you to explore how this opportunity can be tailored to meet your learning needs.
Section A: Information

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* 1. Name:

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* 2. Position / Professional Designation:

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* 3. Area of practice:

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* 4. Address:

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* 5. Cell phone Number:

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* 6. Business Phone Number:

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* 8. Agency/ Hospital/Institution Name:

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* 9. Agency/Hospital/Institution Address:

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* 10. Agency/Hospital/Institution Phone Number:

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* 11. What are your organization's desired topics?

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* 12. What are your ogranization's learning objectives?

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* 13. Expected Start Date (dd/mm/yyyy):

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* 14. How many learners will participate in the requested program?

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* 15. How many virtual sessions to be included in the requested program?

Section B: Attachments

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* 16. Please feel free to attach any relevant information to your request.

Please allow 5-7 business days to process your application. Once your application has been reviewed, you will be contacted for further information.
Your personal information is collected under the authority of the Public Hospitals Act R.S.O 1990, c. P.40 and will be used by SickKids for the purpose of evaluating your suitability for acceptance into the International Learner Program. In the event that we move forward with your application, your personal information may be disclosed to SickKids staff involved in planning your learning experience.

By submitting this application you consent to the above collection, use and disclosure of your personal information by SickKids. Questions about the collection of your personal information can be directed to the Privacy Office: 555 University Avenue , Toronto, Ontario, M5G 1X8, (416)813-6190 or privacy.office@sickkids.ca.

I represent and warrant to SickKids that all of the personal information about me that I am submitting to SickKids is complete and accurate.

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* 17. Signature:

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* 18. Date:

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