Medcoach 2020 Mentee Sign-up Sheet
This form is meant to match you up with a mentor most alike your background, so that you can have the best advice fitted to your circumstances. This information will not be shared or used for any other purpose other than matching you with a mentor. If you have a specific preference for a mentor like gender, ethnicity, etc, please answer questions marked (optional). If you have no preference, leave empty.
What is your name?
What is your major/program?
What is your residency status?
Out of state
If you have had a mentor through MedCoach and would like to keep your mentor from last year, please enter their name below:
Black/ African American
Native American/American Indian
Prefer Not to Say
Gender Identity (Optional):
Would you prefer a mentor with Research Experience? (Optional)
Send me a copy of my responses.
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