MARC Mentor Program Enrollment Form
Mentoring can be defined as a developmental relationship in which a more experienced person provides support and guidance to a less experienced person. Mentoring goes beyond the traditional teacher-student relationship - effective mentors serve as advisers, coaches, teachers, sounding boards, cheerleaders, and critics all rolled into one. Mentors give those with less experience an opportunity to improve their understanding of practices, discuss problems, and analyze and learn from mistakes in an atmosphere that is collaborative, constructive, and confidential. Mentoring young people in science can be a powerful, positive influence on their motivation, their success in school, and possibly their career choices.
Email address *
Mentor Profile
Job Title:
Organization Address:
Type of Organization:
Work Phone:
Cell Phone:
Best Way to Contact:
Best Times to Call:
Professional Certifications/Memberships Held:
Research Experience
Number of Years Professional Experience:
Current Job Responsibilities:
Areas of Expertise:
Mentoring Experience
I have mentoring experience:
It is recommended that at least 2 hours each month or 24 hours in one year be set aside for interaction specific to the mentoring relationship. Will it be possible for you to provide this time to the program? If no, please indicate the type / amount of time you could commit in a 12 month period:
I would prefer to mentor (check all that apply):
What do you hope your student will gain from this relationship?
What do you hope to gain from this relationship?
Would you volunteer to be a guest speaker at MA?
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