Mentee Application Form

Please fill out the form below as detailed as possible. The more information that you complete, the easier it is to make a successful match! 

Name *
Name
Phone
Phone
Are you a MN or PhD student? *
Are you doing a thesis or capstone project?
Research indicates that mentorship pairs are more successful when demographics are considered. Complete only what you are comfortable sharing and select the following that describe you.
What do you hope to gain from having a mentor? (e.g. certain skills, knowledge)
It is important to me to be matched with someone in the same stream. *
It is important to me to be matched with someone in the same stream.
It is important to me to be matched with someone from a similar clinical background. *
It is important to me to be matched with someone from a similar clinical background.
It is important to me to be matched with someone in similar personal circumstances? (i.e. another parent, someone working full time, an international student). *
It is important to me to be matched with someone in similar personal circumstances? (i.e. another parent, someone working full time, an international student).
It is important to me to be matched with someone who has similar research interests. *
It is important to me to be matched with someone who has similar research interests.

Matching is not a science and the MENTOR US team does their best to accommodate preferences and create matches that are the right fit. The program is focused on the success of its members so please let the leadership team know if a match isn't working! We are here to support you.