Please fill in the application form to the best of your ability.

Some important things to note:

• All information provided on application form is held in strict confidence and collected solely as support to match applicants to a suitable mentor group.
• Applying does not guarantee acceptance into the program.
• There is no charge until you are accepted into and agree to participate in the mentor program. 
• Lighthouse’s goal is to maximize your mentor experience by partnering you with like-minded professionals to create an optimal, confidential and comfortable learning environment.