Indigenous Student Mentor Application Form

Applicant information

Information collected will be used for official mentor program business.

Name

Indigenous ancestry

TRU student number

Are you full-time or part-time?

Full-timePart-time

Year of program

Mailing address

Contact phone number

Preferred email address

Availability

As a mentor, you would be required to keep the Cplul’kw’ten (The Gathering Place) open in the evenings one night a week from 5 p.m. to 7 p.m.

Are you available at least one night a week Monday to Friday (from 5 p.m. to 7 p.m.)?

YesNo

Education and background

Summarize your educational background, training, and any awards/accomplishments. (Attach resume, if needed).

Education

Training/certificates

Awards/accomplishments

Memberships/clubs

Upload resume

Previous volunteer experience and other skills and qualifications

Summarize your previous volunteer experience and other assets you think make you a good mentor:

Tell us about yourself

What motivated you to apply to be an Indigenous Mentor here at TRU?

What do you hope to gain from this experience?

Personal character references

Please list references who are non-relatives and who are able to speak to your work, volunteering and personal character.

Reference

Name

Relationship

Phone

Commitment agreement and signature

By submitting this application, you affirm that the facts set forth in it are true and complete. You are aware there will be a minimum commitment of time as directed by the coordinator. You understand that if accepted as an Indigenous mentor, any false statements, omissions, or other misrepresentations made by you on this application may result in immediate dismissal from the program.

Are you at least 18 years old?

YesNo

Name

By typing your full legal name, you have officially have signed this form

Date

Contact Information