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2021-2022 PhysioMP Registration for [Undergraduate Mentors]
Please enter the form details below to become a mentor for new PSL undergraduates.
Due to COVID, mentorship interactions may be fully virtual depending on you and your mentee.
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* Indicates required question
Email
*
Your email
UTOR ID (if you wish to receive CCR;
https://physiomp.com/requirements-for-ccr/
)
Your answer
Student number (if you wish to receive CCR;
https://physiomp.com/requirements-for-ccr/
)
Your answer
First Name
*
Your answer
Last Name
*
Your answer
Program (Physiology)
*
Specialist
Major
Minor
Year of Study
*
3
4
5+
# of mentees you are willing to accept:
*
1
2
3
What are you hoping to gain from this mentorship experience? Please select all that apply:
*
Greater involvement in the department
Having my expertise/experiences recognized
The opportunity to give back/share my experiences
Sharing/learning about the experiences of others
Gaining a greater sense of belonging in the department
Other:
Required
What are your experiences & specialties? Please select all that apply (in order to better match with mentees of similar interests):
*
Clubs & sports
Research
Leadership involvement
Volunteering
Other:
Required
Choose 3 to 5 of the following characteristics that others would describe you as:
*
Approachable
Caring
Empathetic
Enthusiastic
Friendly
Fun
Knowledgeable
Organized
Patient
Responsible
Other:
Required
Please select all that apply (in order to better match with mentees of similar background):
*
Commuter
First in family to pursue university
International student
Thinking of pursuing graduate or professional school
None of the above
Required
Additional comments that you would like to provide:
Your answer
Send me a copy of my responses.
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