Learning & Development Application Intake Form
Thank you for your interest in joining HB² Leadership Coaching's Leadership Practicum Program. 

*Note: Due to the nature of this program, this program is only available to serve those that are Canadian citizens, permanent residents or persons with refugee status. 

Please complete the application form below. 
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Let's capture your understanding of the program. Are you aware that: 

1. The first phase of the program highlights HB²’s innovative approach offering personalized career and leadership coaching with industry mentors of your choice. The program has a cost of $799. Thanks to our employment partners' generosity, the career and leadership coaching aspect can be fully subsidized/ sponsored. This means you do not have to pay until you receive the sponsorship or subsidy. 

2. The second phase immerses you in real-world projects to enhance your internship project portfolio and create a meaningful impact—all while being compensated for these projects (known as "Leadership Practicums"). Mentees are compensated for Leadership Practicums, with up to $500 CAD upon completion of each practicum. 

3. The program is virtual and designed to accommodate your schedule, allowing you to choose when and how you complete the coaching and practicum, providing a nurturing environment for learning and growth, and fostering a balanced approach to life pursuits.
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Required

Please confirm that you are:

- A citizen, permanent resident or hold refugee status; and

- Legally entitled to work according to the relevant provincial and federal legislation and regulations.

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Required
What is your official first and last name? *
Which email can we contact you at? Please record your most used personal email.  *
Which phone number can we reach you at in case of emergency? 
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In 5 sentences or less, please tell us where you are in your career, why you want to be a part of this program and what new skills you hope to gain out of this experience. Some skill examples could be: reading, writing, numeracy, digital skills, problem solving, communication, creativity and innovation, collaboration and adaptability. *
Tell us in 3 sentences or less what this quote means to you: "Power is not in how much we achieve or accomplish, but in how much we give." *
The program features career coaching with mentors from organizations such as the ones below. Which one(s) are you the most interested in having a coaching session with? 
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What is residential address? (To mail you documents if needed) *
What is your country of origin? If born in Canada, please type Canada. *
Year of birth *
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Self-identified orientation *
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