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PIPA mentor interest form
If you are interested in serving as a mentor for future PARC Increasing Professional Advancement (PIPA) awardees, or learning more about Diversity, Equity & Inclusion Task Team (DEITT) training opportunities, please fill out this form.
Please share your name:
Please share your name:
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Please share your email:
Please share your email:
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Please indicate your PARC region(s):
Please indicate your PARC region(s):
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What is your familiarity with recent (past ~10 years) principles in critical and inclusive mentorship?
What is your familiarity with recent (past ~10 years) principles in critical and inclusive mentorship?
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Do you feel you need more guidance or training on mentoring techniques?
Do you feel you need more guidance or training on mentoring techniques?
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If yes to above, what types of topics would you be interested in?
If yes to above, what types of topics would you be interested in?
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Are you willing to (virtually) mentor someone outside of your region?
Are you willing to (virtually) mentor someone outside of your region?
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What is your capacity to be a mentor? Note availability (# hours could commit per month, which months available, interest in mentorship, experience with mentorship)
What is your capacity to be a mentor? Note availability (# hours could commit per month, which months available, interest in mentorship, experience with mentorship)
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Would you be available to serve as a virtual mentor for the NEPARC meeting Aug. 10-13, 2021?
Would you be available to serve as a virtual mentor for the NEPARC meeting Aug. 10-13, 2021?
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If you answered you would like more information about serving as a virtual NEPARC mentor, what information would you like?
If you answered you would like more information about serving as a virtual NEPARC mentor, what information would you like?
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Please let us know if there is anything else you'd like to share.
Please let us know if there is anything else you'd like to share.
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