2025 Mentee Sign-Up Form

2025 Mentee Sign-Up Form

Contact information

Last Name*

First Name*

Degree(s)*

Job Title

Institution/Employer*

Email*

Tell Us About Yourself

Experience in College Health*

1-3 years

4-10 years

11-20 years

21+ years

Area(s) of Practice*

Select all that apply.

Administration

Clinical Services

Health Promotion and Wellness

Mental Health

Student Affairs

Student Population*

2,500 or less

2,500-4,999

5,000-9,999

10,000-19,999

20,000 or more

Mentoring Topic*

Select up to three topics you are interested in discussing with your mentor. Note that we might not be able to match you with someone with expertise in all areas.

Accreditation and Policy

Advocacy

Assessment

Clinical Care

Collaborative Environments

EHR and Technology

Improving Outcomes

Insurance

Leadership and Career Development

Mental Health

Marketing

Non-Discrimination

Operations and Finance

Outsourcing

Professional Development

SHAC

Wellness Programs/Services

Other (see next question)

Your Availability

Availability*

Please indicate the times you are available on Thursday, May 29. Note that the more times you choose, the more likely it will be for us to match you with a mentor that meets your needs.

8:00 am - 8:40 am

8:50 am - 9:30 am

10:00 am - 10:40 am

10:50 am - 11:30 am

1:30 pm - 2:10 pm

3:00 pm - 3:40 pm

3:50 pm - 4:30 pm

I am not available at any of these times but would be willing to meet with a mentee at a another time.

Send me a copy of my responses

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