Mentor Application for DisabledInSTEM 2024
Thank you for your interest in becoming a mentor for DisabledInSTEM! Here, we aim to provide people with disabilities a mentor to help guide them through their careers as they enter STEM. If you have a disability, that is great! If you don't and want to support the cause, we still appreciate your commitment! 

Now in the third year of the program, we are changing it up a bit to now offer mentoring pods. We have found that mentoring pods are more effective as it allows for more interactions and puts less pressure on each individual. We ask that mentors guide their mentoring pods, such as by organizing monthly check-in meetings along with setting goals/tasks to be completed. Tasks may be reading assignments related to a career, attending a conference, talking to someone else in the field, or anything else! Depending on the interest in the program, we aim to have 2-3 mentors per pod. 

Additional information about the mentoring program can be found here: https://docs.google.com/document/d/1P0oGj1eIUhGsJq7oISJnL4RlnZPkFic7FK1vPDxFzk0/edit?usp=sharing

If you have any additional questions, feel free to contact: disabledinstem@gmail.com 
Email *
What is your name? *
What are your pronouns?
What timezone are you in? *
Are you disabled? You do not need to be disabled to serve as a mentor for this program! Some mentees ask to be placed with disabled mentors so this information is helpful to have.  *
If you are disabled, are you comfortable sharing your disability? Some mentees prefer to be matched by specific disabilities. Disclosure is not required to participate and information will not be passed onto anyone else in the program. 
What is your occupation? *
What field of STEM are you in? *
What is your specific field of STEM? This will help with matching more closely!  *
Are you willing to commit to help someone with a disability succeed? *
Have you served as a mentor before? *
Have you been part of the DisabledInSTEM Mentorship Program before? *
Do you want to mentor someone in a particular field/particular disability?
Please share your LinkedIn if you have one. These will be given to the mentoring pods during introductions. 
Why do you want to serve as a mentor for someone with a disability? Responses may be used on social media for advertisement but will remain anonymous unless you state otherwise.  *
What do you hope to take away from participating in this program?  *
Do you have any further suggestions on how to tailor this program?
Is there anything you wish you had known as you pursued your path?  Responses may be used on social media for advertisement but will remain anonymous unless you state otherwise. 
What is one small piece of wisdom that you would be willing to share?  Responses may be used on social media for advertisement but will remain anonymous unless you state otherwise. 
I agree that DisabledInSTEM can use my data for the sole purpose of matching me in a mentoring pod and for contacting me in relation to this Mentorship Program.  I understand that DisabledInSTEM will not be held responsible for any disappointment with the program or any conflicts that may arise.  *
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