Mentorship Program (UC Davis AMSA)
Welcome to the UC Davis American Medical Student Association!
***With all due respect, this database is available to PAID AMSA members only.***

If you are interested in becoming an AMSA mentor/mentee, please fill out this form for us to know you better and find the best match for you. As a reminder, our student association is comprised of undergraduates, medical students, physicians, and various healthcare professionals.

◈ Applying to be a mentor will grant 3 membership points
◈ Applying to be a mentee will grant 1 membership point
◈ You will paired with a mentee/mentor, which is expected to be a minimum 2-quarter commitment

We will not keep track of your interactions with your mentees/mentors. If you would like to be swapped and/or have any questions/concerns, please email us at

Please provide your UC Davis email address below.
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Please confirm that you are a paid member of UC Davis AMSA *
See official roster:
Class Standing *
As of this quarter
Major(s)/Minor(s) *
If Undeclared, what field/study are you interested in?
Please indicate which of the following apply to you:
If there are any additional exceptions, please fill out a 1-sentence description in Other
What role are you interested in? *
Medical students and undergraduates may both become mentors if they are interested.
Mission Statement
The three main pillars of the American Medical Student Association are Education, Mentorship, and Community.

We along with our sister chapters and on-campus student communities strive to create a diverse and inclusive environment for all participating members.

In the past, UC Davis AMSA has written statements focused on Diversity and Inclusion as it follows our mission statement to prepare pre-health students of all backgrounds to become knowledgeable and well-rounded candidates through scholarship, networking, philanthropy, and community partnership.

With all due respect, we would like members to share their demographic information as it will provide meaningful data about the members in our community.

The following questions are optional and all responses will be kept confidential.
Thank you for your consideration and please contact us at if you have any concerns.

Pronouns (optional)
i.e. they/them/theirs, she/her/hers, he/him/his, etc.
Race/Ethnicity(ies) (optional)
i.e. Hispanic and Asian American - Filipino
Gender Identity (optional)
i.e. Cis male, Cis female, Non-binary, Trans male, Trans female, etc.
Clear form
Never submit passwords through Google Forms.
This form was created inside of UC Davis. Report Abuse