Mentorship Program Application for Graduate Student Mentees
Are you a first-time applicant?
Degree program and specialty area (e.g., Ph.D. in Clinical Psychology):
Year in program (if currently on internship, please specify):
Please check off one or more boxes below to indicate your research and/or clinical interests:
What are your long-term career goals and ideal work setting once you have completed your degree (you may select more than one option)?
Academic position in a university setting
Research position in an institution (e.g., VA Hospital)
Clinical position in an institution (e.g., community clinic, hospital)
What are your goals and what do you hope to gain from participating in this program?
Do you have any preferences regarding a mentor (e.g., gender, racial/ethnic background, clinical interests, etc.)? If so, please explain.
Are you willing to communicate with your mentor at least once/month?
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