NextGen Mutual Mentorship Program
Application for Participation
Personal Information
Name
First Name
Last Name
E-mail
example@example.com
Professional Title
Location
Questions and Details
What role does music play in your life?
Where are you in your professional journey?
Emerging
Established
Very Experienced
What do you hope to get out of the program?
What would you describe as your strengths and interests? What do you feel you could contribute to others?
What are the areas for further growth and development you would like to specifically focus on?
Below are the cross-sectoral areas as noted in our Policy Summit Report. In which area do you wish to focus?
Music Impact in Community and Society Today
Inclusion, Diversity, Equity, Accessibility
Health & Well-being
Reimagining and Innovating Professional Practice
I agree to commit to the program for the full 6 months, and authorize the Coalition for Music Education in Canada to use my name, and capture photographs and video recordings of this virtual event in which I appear.I acknowledge that photos or videos might be used for future promotional materials (website, highlight videos, social media, etc.) or in pursuit of grants or funding.
Yes
No
Signature
Submit
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