AWIS group mentoring sign-up
Please answer the following questions to sign-up for the AWIS group mentoring program. Note that filling out this form does not guarantee you a place in the 2016-2017 program. In the future, you will be contacted to confirm your interest in the program.
What is your name? (First and Last)
What is the best email address to contact you at?
I am a(n)...
Early career scientist
If you answered "Other" above, please elaborate
Have you been in the AWIS mentoring program before?
If so, would you like to remain in your group?
What is your ideal future career option?
Scientist at a Biotechnology company
Alternative career path
Please rate your talkativeness level on a scale from 1-5 (1- very quiet, 5-very talkative)
What type of group-wide event would you be most interested in attending?
Mentor career panel
Networking happy hour
If you selected other, do you have any suggestions?
By filling out this form, you agree that you will respect the confidentiality, time, and effort of the rest of your group members and do your best to attend and participate in regular meetings
I do not agree
Is there any other information you'd like to share to help us match you in an appropriate group?
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