1. Workplace Wellness Mentors – sharing experiences Launching May 13 th & 14 th, 2014

2. Workplace Wellness Mentors – sharing experiences Providing opportunities for workplaces to connect with and learn from other workplaces who have demonstrated a level of expertise and success within a comprehensive approach to workplace wellness

3. Responsibilities of Mentors: Be part of Mentor database housed by the Community of Practice Review Mentee applications Connect with potential Mentees and establish preferred method of contact/frequency of meetings etc. Share experiences and contribute to sustainability of workplace wellness in NB Complete one page summary at end of each year

4. Responsibilities of Mentees: Review online Community of Practice Mentor database and select most appropriate match for your needs Complete application form and send directly to Mentor Prepare for first meeting Establish preferred method of contact/frequency of meetings etc. Complete one page summary at end of each year

5. Application Form for Mentees Please complete the following form and send directly to the Mentor: Date:_____________________ Name of Organization: _________ Contact person: ____________ Title: ______________ Indicate your preferred method of contact with the Mentor: [] Phone:[] Email: [] In person PILLARS STRATEGIES Healthy Eating Physical Activity Tobacco Free Living Psychological Wellness/ Mental Fitness Comprehensive Awareness & Education Skill Building & Learning Environment Policy Please indicate below which pillar and strategy you are most interested in learning more about from a New Brunswick Workplace Wellness Mentor:

6. Mentor Summary Form Please provide your feedback for the NB Workplace Wellness Community of Practice regarding your experience as a Mentor: Date:_____________________ Name of your Organization: _________ How many organizations did you mentor in the past year? ______________ Indicate your preferred method of contact with the Mentor: [] Phone:[] Email: [] In person PILLARS STRATEGIES Healthy Eating Physical Activity Tobacco Free Living Psychological Wellness/ Mental Fitness Comprehensive Awareness & Education Skill Building & Learning Environment Policy Please add the number of organizations you helped for each pillar and strategy: Rate your overall experience: Very satisfying [ ] Satisfying [ ] Not very satisfying [ ] Very unsatisfying [ ]

7. Mentee Summary Form Please provide your feedback for the NB Workplace Wellness Community of Practice regarding your experience receiving support from a Mentor. Date:_____________________ Name of your Organization: _________ Organization who provided mentorship for you: ______________ PILLARS STRATEGIES Healthy Eating Physical Activity Tobacco Free Living Psychological Wellness/ Mental Fitness Comprehensive Awareness & Education Skill Building & Learning Environment Policy Please indicate which pillars and strategies for which you were seeking support: Rate your overall experience: Very satisfying [ ] Satisfying [ ] Not very satisfying [ ] Very unsatisfying [ ]

8. To access the New Brunswick Workplace Wellness Community of Practice Mentor package and a variety of many other resources: www.heartandstroke.nb.ca/workplacewellness www.fmcoeur.nb.ca/mieux-êtreautravail