Personal information
9-Digit Student Number (e.g. 001234567)
E.g. What can a mentor help you with? What would you like to get out of the program?
Please limit your response to maximum 500 words.
E.g. interests, hobbies, personal/academic/career goals
Please limit your response to maximum 500 words.
What statement fits you best?

This program is approved for Co-Curricular Record recognition and the following is needed to receive recognition at the end of the year:

  • Attend as many monthly meetings possible, in particular the September meeting
  • Receive a minimum 2 hours of peer mentoring per term (4 hours total)
  • Complete a year-end program evaluation

Is there anything you would like me to keep in mind when pairing you with a mentor?
E.g., I would be more comfortable with a female mentor; I have a learning disability, etc.

Your preferences will be accommodated as much as possible and I will try to match you with a mentor in a similar field of study, but it is not guaranteed. 
Please limit your answer to a maximum of 500 words. 

This personal information is being collected under the authority of the University of Manitoba Act and will be used for Indigenous Student Centre program management. It will not be used or disclosed for other purposes, unless permitted by the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection of your personal information, contact the Access and Privacy Office (204-474-9462), 233 Elizabeth Dafoe Library, University of Manitoba, Winnipeg, MB R3T 2N2.