Indigenous Student Mentor Application Form

Information collected will be used for official mentor program business.

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.

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

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

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.