JMSA Mentorship Form

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JMSA Mentorship Form - Students

Fill out this form if you are interested in being paired with a Japanese/Japanese-American medical professional!

We are periodically checking the forms. We are expecting to match our next cohort of students around October or November of 2023. Please check the JMSA mentorship site found here for updates!

For more information, please email us at jmsa.student@gmail.com

Name *

Email *

Are you a pre-med or a medical student? *

Pre-med

Medical student

Name of medical school / undergraduate college *

Year *

MS 1

MS 2

MS 3

MS 4

MS 5 (Japanese med students)

MS 6 (Japanese med students)

Other:

What specialty are you interested in? (You can list more than one!) *

If you are an undergraduate student, would you like a medical student mentor?

Yes

Clear selection

What are your interests? (hobbies, research, etc.)

What questions would you want to ask your mentor?

This mentorship program is still at its initial stages. What advice do you have? What are important qualities of a mentorship program you would want to be a part of?

Suggestions for any activities/events you would like for JMSA to organize in the future?

Questions/Comments

Submit

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