2021 AWIS East Bay Mentorship Program Interest Form
Our goals are to provide fresh career perspectives for an evolving workforce, to create a network of support for scientists at all levels of their careers, and to generate informed, skilled, and confident leaders. The mentorship program will expand on the traditional two-way mentorship model, what we are calling a “learning pair” or
“learning group”. A learning group acknowledges that knowledge flows not only from mentor to mentee, but from mentee to mentor, and peer-to-peer.
 
The general outline of the program is described below and more information can be found on our website https://ebawis.org/mentorship.
 

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What is your email address? *
First name: *
Last name: *
Are you an AWIS member? *
What's your affiliation? (Work, School, etc.) *
What is your current title?
How would you describe your current career level? *
Which sector are you in? If you are a student, which sector(s) are you interested in being in? *
Required
Which sector(s) are you interested in networking with? *
Required
OPTIONAL : What is your role within your organization (administrative/management, research, marketing, etc.)?
OPTIONAL: Have you participated in a mentorship relationship or program before?
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OPTIONAL: What do you hope to gain in participating in this mentorship program?
Are you able to attend the virtual networking (6/17) and kick-off event (6/24)? *
OPTIONAL: How did you hear about us?
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