VSHP Mentorship Program Mentor Application
Hello VSHP Members!

Thank you for your interest in the VSHP Mentorship Program. Each year, there is expanding interest among pharmacy students to pursue a career in health-system pharmacy. Due to this growth, VSHP would like to provide a stress-free environment for students to interact with pharmacists who share similar interests and backgrounds. The VSHP Mentorship Program is designed to provide an outlet for pharmacy students in Virginia to gain guidance and advice regarding their career paths in pharmacy. We are grateful that you are willing to participate as a mentor!

Each mentor/mentee pairing lasts for 1 academic school year (or more) and the amount of time dedicated to the relationship is dependent upon the student and pharmacist. The mentorship could be in the form of a few emails throughout the year to a day of shadowing or even meeting up for a cup of coffee to discuss pharmacy and life matters. In the past, students have voiced their sincere appreciation of having a mentor and the positive impact it had on their pharmacy education and career.

As a reminder, to continue to be involved with the mentorship program, mentors must reapply each year.

The following are the requirements to be a mentor:
1. Must be a health-system pharmacist
2. Provide guidance, encouragement, motivation and support to the mentee in selecting and developing post-graduate goals and opportunities
3. Maintain at least one monthly contact (via phone, E-Mail) with the mentee
4. Acquaint the mentee with the mentor’s area of practice and discuss various curricular options whereby he/she can gain expertise in this area if desired
5. Expand the mentee’s network of contacts with other pharmacists in the field if opportunities arise
6. Identify resources to help the mentee enhance personal development and career growth
7. Provide continuous advice and feedback

In order to accurately match students and mentors according to interest, please fill out this information below. Information listed below will only be made available to members of the VSHP Mentorship Committee and the student mentee matched to the pharmacist.

Please contact the VSHP Mentorship Program Chairs at contact@vshp.org with any questions that you may have. If at any point you are no longer interested or unable to participate in the VSHP Mentorship Program, please do not hesitate to let the Mentorship Program Chairs know and you will be removed from the list.

Thank you for your support!

Name *
Your answer
Contact E-mail *
Please provide the e-mail address that you would like the VSHP Mentorship Program and student mentees to use.
Your answer
Contact Phone Number
Please provide the phone number that you wish to have the VSHP Mentorship Program provide to your mentee. (This is optional)
Your answer
What is your preferred method of communication? *
What region are you affiliated with? *
Place of Employment *
If at multiple locations, please list all.
Your answer
Work Address *
Please provide the address of your work so as to match students to mentors in their geographical area. Street address/City
Your answer
Position Title *
Your answer
What areas of pharmacy have you practiced in? *
Please select all that apply. This information will help match students to mentors with similar interests.
Required
How many mentees are you willing to take for each academic year? *
By denoting you would accept more than 1 mentee, it does not guarantee you will be placed with more than 1. This only indicates that you are willing to be a mentor to more than 1 mentee per year.
*
Please let us know if you have any additional questions or comments.
Thank you!
Your answer
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