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CALL FOR MENTORS: Successfully Navigating Your PhD: A Mentoring Workshop for 3rd+ Year Women & Non-Binary PhD Students in Health Economics & Health Policy
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Full Name
*
Your answer
E-mail address (this is the address we will use to send you workshop info and Zoom link)
*
Your answer
Employer / Institution Name
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Your answer
Department (if applicable)
Your answer
What is your job title?
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Your answer
What is your PhD degree in?
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Economics
Health Policy
Public Policy
Other
If you selected "Other" for PhD degree, please specify.
Your answer
In what year did you receive your PhD degree?
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Your answer
Gender Identity
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Woman
Man
Non-Binary / Non-Conforming
Prefer not to disclose
Other
Race (select one or more categories)
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American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Prefer not to disclose
Other
Required
Are you of Hispanic, Latino/a/x, or of Spanish origin? (select one or more categories)
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No, not of Hispanic, Latino/a/x, or Spanish origin
Yes, Mexican, Mexican American, Chicano/a/x
Yes, Puerto Rican
Yes, Cuban
Yes, Another Hispanic, Latino/a/x or Spanish origin
Some other race, ethnicity, or origin
Prefer not to disclose
Required
Please select the field that most closely aligns with your research interests (this may be used to assist us with group assignments)
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Mental Health/ Substance Use/Diet/ Crime & Health
Climate/Pollution/Environmental & Health
Competition in Health Care Markets/ Health care financing/Insurer and Provider Behaviors
Demand for and Effect of Health Insurance/ Consumer Decision Making in Health Care
Health Disparities, Health Equity, and Social Determinants of Health
Health, Labor Markets, and the Economy
Long Term Care, Aging & Demography
Maternal, Child, Sexual and Reproductive Health
Other
If you selected "Other" for your field, please specify below:
Your answer
Have you previously served as a mentor in a similar workshop?
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Yes
No
Please confirm that you are available on Friday, Sep. 29, 2023, from 9am to 3pm PT to participate in the workshop on Zoom.
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I am available on Friday, Sep. 29, 2023 from 9am to 3pm PT to participate on Zoom.
I am only available for part of the day of the workshop (please email workshop coordinators to discuss)
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