2024-25 EPiC Graduate Mentor Application
Thank you for your interest in the Emory Pipeline Collaborative (EPiC)!

EPiC is a federally-funded program to prepare high school students for college success and entry into health careers by increasing students' academic achievement, college readiness, social support (mentoring), and health career awareness and self-efficacy.

As a graduate mentor, you will lead a small group of high school students and undergraduate mentors; themes are determined by grade: 
  • Sophomores: Human Sexuality and Reproductive Health
  • Juniors: Neurology and Mental Health
  • Seniors: Public Health and Health Equity
Please contact the president of EPiC, Vivek Prasad (vivek.prasad@emory.edu) with any questions.

Please submit your application by Monday, September 16th 2024 at 11:59pm.
Sign in to Google to save your progress. Learn more
Full name *
Pronouns *
Emory Student ID (for SGA purposes) *
Emory Email Address *
Have you been involved in Emory Pipeline Collaborative in the past?
If yes, please be sure to indicate in what capacity in the "Teaching Experience" section below. 
 *
Undergraduate College/University *
Undergraduate Major *
Current Graduate Program *
First choice for the curriculum you would like to teach:
 *
Second choice for the curriculum you would like to teach:
 *
Third choice for the curriculum you would like to teach:
 *
Career Objectives:
Please briefly describe your career aspirations and how participation in the Pipeline Program aligns with those interests (maximum 200 words)
 *
Teaching Experience:
Have you previously participated in a teaching or tutoring program? If yes, please describe your involvement (including names of programs, dates of service, and your role) and how you plan to apply your experience to the Pipeline Program. If not, please describe other experiences that you feel make you a good candidate as a Pipeline teacher (maximum 250 words)
 *
Mentoring Experience:
Please describe any experiences you have had either as a mentor or as a mentee. How will those experiences help make you an excellent mentor for our Emory undergraduate and high school students involved in the Pipeline Program? (maximum 250 words)
 *
The Emory Pipeline Collaborative is designed to provide healthcare exposure and college readiness opportunities to 10th-12th grade students from traditionally marginalized societies. What experience do you have with this specific population?
 *
Will your schedule allow you to be available between from 4pm-7pm every Wednesday in Spring 2025 (mid-January-end of April) excluding spring break?  
 *
If you answered 'no' to the above question and would like to elaborate on your potential conflict, you may elaborate here. 
Are you available to attend two mandatory teacher training sessions between November-January? (likely either weekday evening or a Saturday; options for dates and times will be sent in advance)
 *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms