Alumni Mentorship Program – Graduate Student Application

Name:*

First Last

Email:*

Primary Phone:*

Home Address:*

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

Anticipated BUSPH Year of Graduation:*

What is 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 participate in the BUSPH Mentorship Program?*

What industry or sectors are you interested in pursuing for your career? (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 specific goals to you hope to accomplish by having a mentor (examples: knowledge, skills, abilities, milestone, etc.)?*

[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.

‘No Community Is Healthy Until All of Its Constituents Are Healthy’

The Long Game of Pride

Alumni Mentorship Program – Graduate Student Application.

BUSPH Alumni Mentorship Application - Graduate Students

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.