MENTOR APPLICATION
Thank you for your interest in our Mentoring Program. All prospective Mentors are asked to read the
Mentor-Mentee Guidelines before completing this application and e-mailing it to the committee. Because
only those application forms which are complete may be considered further, please ensure you answer each
question in its entirety. Successful mentor applicants must:
 Maintain their CHRP designation or be a working HR professional for a minimum of 10 years, AND
 Be a Chapter member in good standing.
Info collected for the Mentorship Program is for the sole purpose of matching Mentors and Mentees and will not be shared in any
other way.
Please e-mail completed application to: mentorship@gdhrpa.ca
APPLICATION FOR MENTORING PROGRAM: MENTOR
PERSONAL INFORMATION
PROFESSIONAL INFORMATION
Name: Click here to enter text.
Address: Click here to enter text.
Phone: Click here to enter text.
E-mail: Click here to enter text.
Membership Status: Choose an item.
Years in HR: Click here to enter text.
Employer: Click here to enter text.
Title: Click here to enter text.
Address: Click here to enter text.
Phone: Click here to enter text.
E-mail: Click here to enter text.
Best time to contact you: Choose an item.
Resume attached: Choose an item.
QUESTIONS
Your preference is to mentor:
☐ A recent graduate working on achieving the CHRP and working in the field of HR
☐ A recent graduate having achieved the CHRP and working in the field of HR
☐ A person working in HR with more than 1 and less than 5 years experience
Why are you interested in participating in the Mentor-Mentee Program?
Click here to enter text.
Your Mentee would possess the following specific qualities:
Click here to enter text.
Do you have previous coaching and/or mentoring experience? If so, please describe.
Click here to enter text.
You offer experience in:
☐ Private Sector
☐ Public Sector
☐ Union Environment
☐ Not-for-Profit Sector
Mentor Application v052011
☐ Small organization (<500 employees)
☐ Medium organization (500-1000 employees)
☐ Large organization (>1000 employees)
☐ Corporate Office
☐ Local Office
☐ Generalist
☐ Specialist
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Please identify your top 3 areas of interest and desire to mentor in, using 1 as your first choice.
☐ Benefits
☐ HR Information Systems
☐ Policy and Process
☐ Business Partner
☐ HR Planning
☐ Project Management
☐ Change Management
☐ International HR
☐ Recognition and Rewards
☐ Coaching
☐ Job Evaluation
☐ Recruitment
☐ Total Compensation
☐ Labour Relations
☐ Retention
☐ Competencies
☐ Leadership
☐ HR Strategy
☐ Consulting
☐ Legislation
☐ Succession Planning
☐ Diversity
☐ Management
☐ Team Building
☐ Employment Equity
☐ Organizational Development
☐ Training
☐ Employee Relations
☐ Pay Equity
☐ Salary Administration
☐ Ethics
☐ Pension Administration
☐ Variable Pay
☐ Health & Safety; Wellness
☐ Performance Management
☐ Work-Life Balance
☐ Other
Describe 3 attributes you possess which would contribute to your success as a Mentor:
1.
2.
3.
What other information would you like to share with the committee?:
Click here to enter text.
REFERENCES
Please list 2 references who can confirm your talent, knowledge and skills
Name: Click here to enter text.
Relationship:Click here to enter text.
Phone: Click here to enter text.
Name: Click here to enter text.
Relationship:Click here to enter text.
Phone: Click here to enter text.
Title:Click here to enter text.
Email:Click here to enter text.
Title:Click here to enter text.
Email:Click here to enter text.
MENTOR-MENTEE LIST
This is a list of all current participants provided at the initial launch meeting. I would like to be included in this list:
☐ YES
☐ NO
SIGNED AND DATED
I hereby agree to the terms outlined in the Mentor-Mentee Guidelines and adhere to the Professional Code of Ethics as set by the
Human Resources Professionals Association (HRPA) of Ontario. Further, I understand that provincial Freedom of Information and
Protection of Privacy Act and the federal Personal Information Protection and Electronics Document Act will be respected. I further
commit to devoting a minimum of 2 – 4 hours per month between September and June to the Mentor-Mentee program.
Signature (or type name is sending via email)
Date
Thank you again for your interest.
A member of the Mentorship Committee will acknowledge receipt of your application.
FOR MENTORSHIP COMMITTEE USE ONLY
Date Application Received:
Applicant Status with GDHRPA:
Assigned Mentor:
Mentor Application v052011
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