Alumni Mentorship Program – Alumni Application

I am applying to be a*

MENTOR
MENTEE

Alumni interested in being both a mentor and mentee, please fill out the form twice. Thank you!

Name:*

First Last

Email:*

Primary Phone:*

Home Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job Title:*

Organization Name*

BUSPH Year of Graduation:*

What was your Functional Certificate or Department at BUSPH?*

Community Assessment, Program Design, Implementation, and Evaluation (CAPDIE)
Environmental Health
Epidemiology and Biostatistics
Global Health Program Design, Monitoring, and Evaluation
Health Communication and Promotion
Health Policy and Law
Healthcare Management
Program Management
Other

Please select any context certificates or areas of expertise.*

If you notated "Other" for either of the questions above, please provide additional context.

Undergraduate Degree:

Do you hold any additional degrees?

Why do you want to be a BUSPH mentor?

What industry or sectors have you spent your career in? (e.g., health admin, hospitals/health systems, consulting, community health, government, private, sexual health, mental health, private practice, personal training/exercise science, etc.) Please be as specific as possible.*

What knowledge, skills, or abilities do you possess that you believe would benefit a mentee?*

Note: If signing up as a mentee, please describe the type of career advice you are seeking.

What is the maximum number of students you are willing to mentor?*

Are you willing to serve as a mentor to a fellow alum?*

[Optional] In some cases, mentees indicate a preference to be matched with a mentor that identifies as one of the following. With which of the following do you self identify?

First Generation
International
Person of Color
LGBTQ+
Woman

Note, matching preference will be considered but not guaranteed.

Please provide any additional information you would like us to know to best match you.

Mentors and mentees will be matched primarily using professional area of interest and background along with any other relevant requested criteria, whenever possible. If a compatible match is not available at the time of application, an effort will be made to find one soon thereafter.

Clinic to Classroom and Back: Alum Returns to Nepal to Re-envision Healthcare

Public Health and the Postal Service

Alumni Mentorship Program – Alumni Application.

BUSPH Alumni Mentorship Application - Alumni

Mentors and mentees will be matched primarily using professional area of interest and background along with any other relevant requested criteria, whenever possible. If a compatible match is not available at the time of application, an effort will be made to find one soon thereafter.