2017-2018 CAAHP Mentoring Questionnaire
* Required
Are you interested in being a:
*
Mentor
Mentee
Title
Dr.
Mr.
Ms.
Mrs.
First Name
*
Your answer
Last Name
*
Your answer
College/University
*
Your answer
Job title
*
Your answer
Address 1
*
Your answer
Address 2
Your answer
City
*
Your answer
State Abbrev.
*
Your answer
Zip
*
Your answer
Phone
*
Your answer
Email
*
Your answer
Is your institution:
*
Public
Private
Institutional Set Up:
*
Community College
Undergraduate only
Undergraduate and Graduate
Approximate size of overall student body:
*
1-1,000
1,000-5,000
5,000-10,000
10,000+
Role
*
Academic Advisor
Career Counselor
Faculty Advisor
Dean Advisor
Retired Advisor
Other:
Years of experience in pre-health advising
*
0-3
4-6
7-10
10+
Which description fits your institution best?
*
Solo Pre-Health Advisor on campus
Centralized pre-health advising office
Multiple, decentralized pre-health advising units
Other:
Health Professions Advising Mentoring offered or sought...
Mostly Medicine
Yes
All Health Professions
Yes
Other please specify
Your answer
Does your campus have a pre-health committee?
Yes
No
Optional comments about pre-health committee's set up
Your answer
Please enter any additional information you deem useful in matching you with a mentor/mentee in the Central Region.
Your answer
Submit
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