Mentee Registration Form

Ignite Your Potential as a Mentee!

Enroll in the Region of Waterloo Upstream Mentorship Program, taking place from

Oct 16 – to Nov 24, 2023

Join us in connecting and empowering the African, Caribbean, and Black (ACB) communities of Waterloo Region.

As a mentee, you’ll be paired with a mentor who will provide a secure, enriching space to learn, connect, and grow. Complete the form below and benefit from effective mentor/mentee matches that promote Equity, Diversity, and Inclusion (EDI) for all racialized groups.

Your journey toward your goals begins here, supported by mentors committed to your success. Ready to take the first step? Sign up as a mentee. (Note: Registration does not guarantee your selection as a mentee).

CCAWR Mentee Survey
5. City/Township
7. Preferred method of contact (NOTE: Please ensure you provide the information for the preferred method.) *
10. Ethnicity/Cultural Identity (OPTIONAL: The answer from this question will be used to match you with a mentee that you will be comfortable with and is best suited to your goals, as outlined in question 17 below)
11. Which option best applies to you? *
15. What areas would you like to focus on in this mentorship relationship?
17. Would you like to be matched with a mentee that shares similar interests and characteristics?
18. Please select the options for which you would be available to meet with your mentee? *
19. How many hours a week would you be able to mentor? (This would be in addition to the 1 hr. weekly workshop or seminar)
21. Are you willing to attend a training and orientation session prior to being selected as a mentee? *