Alumni Mentoring Interest Survey Question Title * 1. Personal Information Full Name Phone Number Email Address Question Title * 2. What degree(s) did you earn from UMSPH? Degree Program (i.e. GE, HME, IH, OEE) Year Degree Program (i.e. GE, HME, IH, OEE) Year Degree Program (i.e. GE, HME, IH, OEE) Year Question Title * 3. What is/are your current job title(s)? (please be as specific as possible) Question Title * 4. What best describes your career area? Local public health office State public health office National/governmental public health agency (i.e. CDC) Academia - research Academia - teaching Industry - consulting Industry - research Healthcare - hospital Healthcare - private practice Other (please specify) Question Title * 5. If you work internationally, what countries do you partner with most closely? Question Title * 6. What research area are you most involved with or comfortable with discussing? Question Title * 7. How many students would you be willing to mentor during the year? 1 2 3 4 5 Other (please specify) Question Title * 8. What kind of time commitment are you able to give (per student)? Weekly Biweekly Monthly Other (please specify) Question Title * 9. What is your preferred method of contact? Email Phone Skype call (or other face-to-face webcam communication) In person (if possible) Other (please specify) Thank you very much for your information! We greatly appreciate your time and initiative to volunteer for the inaugural launch of our program. Please look for an email soon from us! Next