Welcome to the Tufts PDA Mentoring Circle Mentee Application
Please complete this application to become a mentee in the 2015-2016 Tufts PDA mentoring circles
Please provide your contact information to help us in matching you with the right Mentoring Circle.
Your name:
Your answer
Your campus:
Your answer
Research focus (STEM/Humanities/Social Science):
Your answer
Career interest (Academic & Tenure Track/Industry/Undecided):
In Which City/Town Do You Reside?
Your answer
Work City/Town:
Your answer
Email Address:
Your answer
Phone number:
Your answer
Have you been a mentee in a mentoring circle before?
What is your current professional position?
What is your current age group?
4. Do you have any objections to being matched with mentees from different age groups?
What is your level of education?
Do you have any objections to being matched with mentees from different educational backgrounds?
7. How many years of professional experience do you have (not including graduate and professional school)?
8. Do you have any objections to being matched with mentees from different levels of professional experience?
Describe your field(s) of expertise and/or professional interest?
Please select the most important area that you would like to focus on in your mentoring circle.
Please select the second most important area that you would like to focus on in your mentoring circle.
Please select the third most important area that you would like to focus on in your mentoring circle.
13. What are your expectations from participating in a mentoring circle? Check all that apply.
Required
What is the most important criteria for your Mentoring Circle peers?
When would you be available to meet with your Mentoring Circle? (check all that apply)
Required
17. Where would you be available to meet with your Mentoring Circle? (check all that apply)
List three or more reasons for wanting to participate in the Tufts PDA Mentoring Program.
Your answer
Is there anything else you would like to tell us about yourself that could help us match you to a mentoring circle?
Your answer
I have read all the instructions pertinent to this application. (Type your name)
Your answer
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