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ASOM Elective Request Form
ASOM participants are eligible to receive a Certificate of Participation if they attend all 6 sessions of the ASOM Series, which are 1.5 hours each (listed below). We know that things come up and prior commitments exist that prevent participants from attending all 6 session. Therefore, participants are able to substitute attendance at one of the ASOM workshops that they cannot attend for attendance at a similar/relevant workshop as an "elective".

++ Only one workshop can be counted++

To be considered for the elective, events must:
- Be at least 1.5 hour long
- Be related to developing skills or broadening perspectives on mentoring or teaching graduate students or postdocs
- Take place during the same academic year that the series is attended




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Name *
Email *
Department *
Graduate Program, if applicable  
Title *
Title of Workshop *
Organizer/Sponsor of the workshop *
Date and Time of the workshop *
How was it related to mentoring? Did you learn anything interesting? Would you recommend it? *
Additional Comments/Thoughts?
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