BGWC Mentor Network
Thank you for volunteering to be a mentor! To help us best match you with your future mentee, please fill out the following form.
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Email *
Full Name *
Gender *
Ethnicity/Race *
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I identify as *
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Where are you located? (city, state, country) *
Are you currently a student? This includes individuals completing post-baccalaureate, graduate, master's and/or professional degree(s). *
Please list the degrees you have obtained to date separated by a comma (ex: BS, MS, MD) *
If you are a student, please describe your current degree program and how far along you are (ex: first year DO student; MD/PhD year 4)
Do you have any preferences in regards to the student you mentor? (ex: men only/women only, first generation student, non-traditional student etc.) *
How would you like to communicate with your mentee? (select one or more responses) *
Required
How many mentees are you willing to take on?
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Instagram Handle
Twitter Handle
Please discuss any additional comments/preferences you have that may help us in matching you with your mentee.
A copy of your responses will be emailed to the address you provided.
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