Project SHORT: Grad School Mentee Form
PLEASE READ: Matches do not expire, so if you were matched with a mentor during a previous cycle, please do not reapply, you can just contact your mentor. If you are no longer in touch with your mentor or have any questions, please contact

*****Due to high demand, we are currently unable to accommodate mentees in several areas, which are noted in the drop down below. Please note that if you apply for one of these areas, we might be unable to match you. Instead, we encourage you to choose a different area of interest if possible.******
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First and last name *
E-mail address (please check for accuracy) *
Matches do not expire, so if you were matched with a mentor during a previous cycle, please do not reapply, you can just contact your mentor.  *
If you previously applied to Project SHORT, please explain why you are reapplying. If this is your first time applying, you can just put N/A. *
What are your pronouns? *
We are collecting the following information for two purposes: To better match you with a mentor with shared life experiences, and to assess our goals for reaching underrepresented applicants. These data will only be seen by Project SHORT committee members. Aggregate counts and percentages may be released, but we will never share or sell your personally identifying information at any point. You may select "prefer not answer" to any questions you do not wish to answer.
In which country do you currently reside? *
In which state do you currently reside? *
Undergraduate university (please include full name, no acronyms) *
How would you categorize your undergraduate institution? *
What is/was your undergraduate major(s)? *
What is your current status? *
How well do you think your experiences have prepared you for graduate school? *
Not well at all
Very well
What academic year do you hope to begin your graduate training? *
Degree program(s) you plan to apply for: *
If you have identified specific schools/programs you plan to apply to (e.g., Temple University’s developmental psychology program), please list them here. If none, then write "None". *
Where do you plan to apply for graduate study? Check all that apply. *
What is the primary program/field you hope to get your degree in? Please choose the closest option. *
What is the secondary program/field you hope to get your degree in? We will use this if there are no available mentors in your primary field. PLEASE CHOOSE SOMETHING OTHER THAN THE FIELD YOU NOTED AS YOUR PRIMARY AREA OF INTEREST *
What are your research interests (use keywords)? The more specific you are, the better we are able to match you to a mentor doing similar work! *
Do you identify as any of the following? (Please check all that apply – but do not feel obligated to disclose anything you are not comfortable sharing.) *
What race/ethnicity(ies) do you identify with? Check all that apply. *
What is your gender? *
Do you have any physical or mental disabilities? *
How would you define your family of origin's class? *
How would you define your current class? *
Project SHORT aims to combat socioeconomic and systemic inequalities in medical and graduate school admissions. What barriers do you face in applying to medical/graduate school? Please note: we will not be able to match you with a mentor if this question is not answered. *
Is there anything else you’d like to share about your life/goals that may help us to better match you with a mentor? *
Do you have experience living/going to school in any other country(ies)? Please list the countries. *
How did you hear about us (check all that apply)? *
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