2025 Mentorship Program Application Form

2025 Women in Leadership Mentorship Application Form
Mentee Application
Full Name*

First NameLast Name
Phone Number*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Are you currently employed?*

YesNoPrefer not to disclose
Do you identify as First Nations, Inuit, Métis, LGBTQ2S+, or as a Woman of Colour?We are asking this question to help ensure we match you with a mentor who shares similar experiences and interests.*

First Nations, Inut, MétisLGBTQ2S+Woman of ColourNeurodiverseNone of the Above
If you identify to one of the four groups in the previous question, WIL in partnership with our Corporate Sponsor is providing a scholarship. If the program fee is a barrier to participate, please indicate yes or no, limited spots are available.

YesNo
Employer*
If you are unemployed, please indicate your past employer.
Title/Position*
Years of Experience*
Industry*
Level of Post Secondary Education*
Are you seeking placement or advancement opportunities in your employment?
WIL supports mentees in securing employment opportunities through our partners on our job portal, Leading Talent. If you would like to be contacted regarding opportunities, please indicate here.
How did you hear about our program? I.e. WIL Partnership Program, Social Media, Newsletter, Word of Mouth.*
Is this your first time registering in the Mentorship Program?

YesNo
Tell us about your experience with mentorship.*
Why do you want to be a mentee in this program?*
What are your top three professional goals for the next year?*
What are your top three longer term professional goals within the next 5 years?*
Mentor Location Preference
Our Mentees are located in the US and Canada. If you would like to be matched with a mentor within your time zone, please indicate here. If you have no preference, please enter 'None'.
What do you hope to accomplish by the end of the program? *
What particular industry/sectors or experience level would you like your mentor to hold or have experience in?*
What are the top three personal qualities you would like to have your mentor embody?*
This role will require a minimum of 1-2 hours on a monthly basis with a minimum of 1 meeting per month. Will you be able to fulfil these requirements?

Yes
I hereby declare that all of the information provided in the Women in Leadership Mentorship Program application is complete and true in every respect.

I accept.
Program Fees:

$350.00 CAD Regular Admission

$150.00 CAD Student Admission

Please pay your program fee through our separate online payment form prior to the application deadline of November 15, 2024 3PM PST.

WIL will not distribute your personal information to any third party without your consent. We thank you for your commitment in empowering and elevating women in leadership across diverse industries! If you have any further questions regarding the application process, please connect with Olaide Akinlabi, Program Lead at the Mentorship Program.

Email: Ola@womeninleadership.ca

Website: www.womeninleadership.ca
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2025 Women in Leadership Mentorship Application Form

Mentee Application