Reasons why you want to become a FGC coordinator. Which of the guiding principles do you think will be the least challenging for you to implement? Which of the guiding principles do you think will be the most challenging for you to implement? Please indicate the constraints you have in completing a mentorship (i.e. geography, time, other employment conflicts etc.) Please indicate the dates and location you completed the required FGC Coordinator Training. Date: Location: I have enclosed the following documents with my application: Application Form Written submission of Statement of Interest Proof of Professional Liability Insurance Coverage Results from a current Police Vulnerable Sector Screen Updated resume Name of Proposed Mentor (if applicable)_________________________ Please be advised that handwritten applications will not be accepted and that any packages that are incomplete will be returned for completion. Consent and Acknowledgment My signature below indicates consent to communication between Mentor/Mentee, Provincial Resource Office and the regional ADR delivery service, if applicable. My signature below also indicates that the information contained in this application package is true and accurate. I understand that submission of this application in no way guarantees approval for mentorship. I understand that securing a mentorship is dependent on the availability of mentors and is not guaranteed by the FGC Ontario Provincial Resource. Signature: Date: The complete application package may be mailed to: The FGC Ontario Provincial Resource The George Hull Centre 81 The East Mall, 3rd floor Toronto, ON M8Z 5W3 Or via fax (416) 622-7068 or email to . Please ensure that the entire signed application package, including all required attachments, is sent with a covering message, in one email message. Thank you for your interest in Family Group Conferencing. A member of the Provincial Resource office will contact you as soon as your application package is processed. For Office Use Only Application Form Written submission of Statement of Interest
Reasons why you want to become a FGC coordinator. Which of the guiding principles do you think will be the least challenging for you to implement? Which of the guiding principles do you think will be the most challenging for you to implement? Please indicate the constraints you have in completing a mentorship (i.e. geography, time, other employment conflicts etc.) Please indicate the dates and location you completed the required FGC Coordinator Training. Date: Location: I have enclosed the following documents with my application: Application Form Written submission of Statement of Interest Proof of Professional Liability Insurance Coverage Results from a current Police Vulnerable Sector Screen Updated resume Name of Proposed Mentor (if applicable)_________________________ Please be advised that handwritten applications will not be accepted and that any packages that are incomplete will be returned for completion. Consent and Acknowledgment My signature below indicates consent to communication between Mentor/Mentee, Provincial Resource Office and the regional ADR delivery service, if applicable. My signature below also indicates that the information contained in this application package is true and accurate. I understand that submission of this application in no way guarantees approval for mentorship. I understand that securing a mentorship is dependent on the availability of mentors and is not guaranteed by the FGC Ontario Provincial Resource. Signature: Date: The complete application package may be mailed to: The FGC Ontario Provincial Resource The George Hull Centre 81 The East Mall, 3rd floor Toronto, ON M8Z 5W3 Or via fax (416) 622-7068 or email to . Please ensure that the entire signed application package, including all required attachments, is sent with a covering message, in one email message. Thank you for your interest in Family Group Conferencing. A member of the Provincial Resource office will contact you as soon as your application package is processed. For Office Use Only Application Form Written submission of Statement of Interest
FGC-Mentorship-Application-Revised-August-2015.docx