Name Surname *

Phone Number *

Email *

City *

Province *

How long have you lived in Canada? Less than 1 year1-3 years3-5 yearsbetween 5-15 yearsbetween 15-30 yearsmore than 30+ years

What is your occupation? *

What is your industry? *

Which company do you work in?
- If you are a student, which school are you in and what is the program you are studying?
- If you are running your own business, what is the name of your company?

Are there any other communities that you are a member or volunteer of?
If yes, what are the activities you are involved in or the responsibilities you have taken within the scope of your participation?

Have you been involved in mentor-mentee programs before in your business life?
If so, what was your role?

Would you like to mentor those who want to benefit from your experience as part of your TEPAC membership?
(Detailed information will be given on the subject.?
Yes, I want to be a mentor.No, I want to be a mentee.I want to be both a mentor and a mentee.

If your answer is 'I want to be a mentor', in which professional field would you like to benefit the mentees?

What are your expectations from TEPAC during your TEPAC membership? *

To what extent would you like to start your TEPAC membership? Student MembershipProfessional MembershipEntrepreneur/Business Owner Membership

Would you like to sponsor TEPAC events? YesNo
If your answer is yes, please indicate the type of support (financial sponsorship, product sponsorship, service sponsorship, etc.)

Welcome to the TEPAC family! Please do not hesitate to share your valuable comments, complaints and suggestions with us.