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ABPsi Jegnaship Information Form PROFESSIONAL
The Jegnaship Program is a mentorship program created to help connect student members and professional members of ABPSI. This is often facilitated through monthly correspondence via telephone or e-mail contact. This mentoring initiative is a way to give back as well as to be connected in the Student Circle. Jegnaship is a vital part of creating and maintaining relationships between students and professionals, as well as a way to enhance our knowledge and skills as future and current professionals.
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Current Mailing Address:
Your answer
Phone Number:
Your answer
E-mail Address:
*
Your answer
Preferred Method of Contact:
Phone Call
E-mail
All of the above
Clear selection
Returning Jegnaship participant?
Yes
No
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University Affiliation
Your answer
What credential level best describes you?
*
Master's graduate student
Doctoral graduate student
Early Career Professional (individuals with or without a license who has received a doctorate degree in psychology within the past ten years)
Middle Career and beyond Professional
Please further describe your Professional Affiliation/ Title
I.e PhD Student, License Professional, Faculty, PsyD, PhD
Your answer
Research/Clinical Interest:
*
Your answer
Expectations from Jegnee:
Your answer
What do you expect to gain from the jegnaship:
Your answer
Would you like to work with a jegnee that is located close to you?
Yes
No
No preference
Clear selection
Would you be interested in a jegnaship family:
This would include (1) professional, (1) graduate student, and (1) undergraduate Student.
Yes
No
Clear selection
Any other questions or concerns you would like to mention?
Your answer
Do you know a professional member who would make an excellent Jegna? Please Nominate them.
If so, click yes to nominate them!
Yes
No
Clear selection
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