BPAO Mentors & Career-day Speaker Sign-up
BPAO is in the early stages of developing a mentorship program for our medical learners and continues to do outreach talks for pre-medical students. If you are interested in mentorship and/or career-day talks for Black medical and/or Black pre-medical students please fill out the required information below.

Please ensure you choose dissemination options to the requesting students or reps.

NOTE: non-Black allies are always welcome to sign up on this list!

Please indicate N/A where required

Should you have any questions please email us directly at info@bpao.org
First Name *
Last Name *
Phone Number *
Email (Practice email for contact) *
City/Province *
Company/Organization Name *
Please indicate your interest: *
Area of Expertise/ Practice *
How would you like to be contacted by the mentee or rep? *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy