NBTS Mentor Interest Form for Summer 2023
1.
Full Name
*
2.
Email
(Required.)
*
3.
Phone
(Required.)
4.
How would you describe your own ethnicity?
5.
Affiliation:
Oregon State University
Non-profit
Tribe
Industry
Community College
Individual
Other and or description:
6.
Professional title
7.
What is your field of expertise or type of natural science background?
8.
Do you have mentoring experience?
Yes
No
If yes, please describe:
9.
Do you have experience mentoring multicultural students?
Yes
No
If yes, please describe:
10.
What type of mentoring would you say is your strongest?
Academic
Personal development / socio-emotional
Career exploration and development
Other (please specify)
11.
Do you have experience working with Indigenous students or communities?
Yes
No
If yes, please describe:
12.
Are you willing and available to mentor an undergrad student periodically? Time commitment is approximately, or averaging, 30 minutes per week per student.
Yes
No
Maybe
13.
Mentoring may occur over virtual formats (i.e. zoom) or telephone, or in person. Would you consider mentoring an NBTS student intern enrolled at:
Oregon State University
Southwestern Oregon Community College
14.
Do you also have internship opportunities to offer?
Yes
No
If yes, please briefly describe or insert a link to more info.:
Current Progress,
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