Application for Membership

Thank you for your interest in becoming a partner with the Ontario Mentoring Coalition (OMC). Please review and complete the below Partnership Application and submit it to OMC.

Please note that this partnership application may take up to 30 minutes to complete. Allow yourself the time to complete the entire application, as you won’t be able to save your entry mid-way. If you would like to review the information being asked in the application prior to completing it, please email us at support@ontariomentoringcoalition.ca.
Tools, guides, and sample documents are available on the following websites to support you in building a quality mentoring program:
www.ontariomentoringcoalition.ca
www.albertamentors.ca
www.mentoring.org

Should you have questions or require further support to fulfill the criteria, please contact OMC. We are happy to support the great work you are doing in the mentoring field.

Name*
Please enter the name of the individual filling out this application.
First Last
Email
Organization Information
Legal name of organization or agency*
Office Phone*
Office E-Mail*
Note: This e-mail will be used as your contact e-mail on your partner profile page.
Fax
Website
Mailing address*
City*
Province*
Postal Code*

Organization Contact
Position*
The position of your organization contact.
Position Other*
If you answered other to your position. Please type in your position title.
Name*
Please enter the first and last names of the main contact for your organization
Title
Salutation
- Mr.
- Mrs.
- Ms.
- Miss
- Dr.
- Rev.
- Hon.
Phone*
Please enter the main phone number for your organizations main contact.
Fax
Cell
Email*
Preferred method of contact

How did you hear about the Ontario Mentoring Coalition?*
What are you hoping to gain and offer as a member of the Ontario Mentoring Coalition?*
How can the Ontario Mentoring Coalition best support your organization and mentoring initiatives?*

By submitting this application, I verify that*
You need to agree to all of the following options for the form submit button to appear.
- The information communicated in this application is true, accurate and current.
- My organization has authorized and approved the submission of this document.
- My organization will do everything in its power to fulfill the requirements as stated in the Ontario Mentorship Coalition Criteria.
- My organization understands that they can request to be removed as an OMC Partner at any time by notifying mentor.support@ontariomentoringcoalition.ca
- My organization agrees to support evaluation activities to contribute to OMC’s sustainability, including the provision of data related to how OMC resources and supports have contributed to program development, when requested.
OMC would like to list your organization as a new member on the website. Do you consent to having OMC share your organization name and profile on the website?*
- Yes
- No
Submitted by*
Please type your name.
Submission date*
Please choose todays date.
Date Format: MM slash DD slash YYYY
Once received, the Alberta Mentoring Partnership will review your application and notify you of acceptance.

Note: The Submit button will not appear until you have selected and agreed to each of the "By submitting this application, I verify that" checkboxes above.
Email
This field is for validation purposes and should be left unchanged.

Step 1 of 5 - Organization Information

Organization Information

Organization Contact

Please identify the children and youth your organization serves: