Mentorship Registration

The IMPulse Mentorship program aims to match young Indigenous Students in Secondary School to Indigenous students in Science, Technology, Engineering, and Mathematics. The IMPulse program can also be a bridge to a variety of opportunities on campus including participation in further learning opportunities with partners such as UBC Geering Up, Let’s talk Science, and UBC Faculty partners to support volunteer, career, learning and research opportunities. Students participating in this program will have access to mentors to discuss University preparation, academic support, and general health and wellness.

IMPulse Mentorship Program 2023

Personal Information
Name*
First Last
Phone*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Age*

If the registrant is under 18, please list their Age
Indigenous Ancestry

This is an optional field if you care to share. This event is being primarily presented for Indigenous students, student registration implies Indigenous Ancestry
Emergency Contact
Name*
First Last
Relationship*
Home Phone*
Cell Phone
Waiver
This section is to be filled out by parent or guardian of student attending.
Name of Parent/Guardian*
First Last
Relationship*
Home Phone*
Declaration of Information*
- By Checking this box I give my child permission to participate in the IMPulse Mentorship Program at the University of British Columbia Vancouver Campus

Mentorship Registration

Mentorship Registration

IMPulse Mentorship Program 2023

Personal Information

Emergency Contact

Waiver