LSO Mentorship - Application

LSO Mentorship Program Application
The LSO Mentorship Program is designed for science and business professionals at any stage of their career, seeking opportunities to develop their career and skills in Life Sciences and related industries. This is not a program to help job-seekers find their next job. All applications will be individually reviewed by the LSO Mentorship Committee to determine eligibility. Acceptance into the LSO Mentorship Program is based on an applicant's: interests and objectives for participating in the program past leadership and work experience LSO membership status (for proteges) Preference will be given to working professionals; however, a limited number of students will be accepted. Please note that matches are based on suitability and availability, and we cannot guarantee that a suitable match will be available even for eligible applicants. Applicants will only be contacted once a suitable match has been identified.
General Information
First Name:
Last Name:
Phone:
Email:
Password:
Verify Password:

Work Experience
Current / most recent sector:
Current / most recent position held:
Current / most recent company / institution:
Years worked in current / most recent sector:
Total years of experience:

Education / Certifications
Education (select all that apply)
Degree	Specialization
Bachelors
BPharm
DDM
DVM
LLB/JD
Masters
MBA
MD
PhD
Other
Certifications (select all that apply)
CFA CMA Other PEng PMP
if Other, specify:

Mentor / Protégé Program
Are you a current LSO member?
Yes No
What program are you interested in?
Becoming a Mentor Becoming a Protégé Both

Desired Meeting Location (select all that apply)	Desired Meeting Frequency (select all that apply)	Desired Program Duration (select all that apply)

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What do you hope to achieve from participating in this program?

Please specify the spoken language(s) you are fluent in:

Please list any interests / hobbies:

Additional Information
LinkedIn Profile URL:
Upload your resume (required):	(Max file size: 2MB)

How did you hear about us?
if Other, specify:

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