SIGUCCS Mentoring Application

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We are accepting applications for mentors and mentees for the SIGUCCS mentoring program. Please complete the information below. The more we know about you and your goals, the better we will be able to pair you with a partner! The program runs from June to April; and during this time, pairings are expected to set goals, be candid with each other, have a willingness to communicate, and meet regularly. Please email the SIGUCCS Mentoring Advisory team if you have any questions, secretary@docs.siguccs.org. Thank you for your interest and your commitment to this profession!

Email *

First Name *

Last Name *

Phone Number *

Can you commit the time? *

To be successful, you must be able to commit time to the mentoring relationship. The actual schedule will be determined by you and your mentor. On average is it a 1 hour commitment per month. Please do not apply if you are unable to commit that time.

Yes

Other:

Are you a SIGUCCS Member?

If not, go to http://www.siguccs.org to join

Yes

No, but I understand that to participate I need to become a member by the time the programs begins.

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Job Title *

Institution *

Years at Your Institution *

Years in Higher Ed *

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