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AVA Triadic Mentorship Scholar-Mentee Application

Scholar-Mentee Background Information



The AVA Triadic Mentorship Program (TMP) is a mentoring program between a scholar-mentee, an AVA community mentor (i.e. community partner agency leader), and an AVA academic mentor (i.e. graduate supervisor). The AVA TMP is intended to supplement/enhance scholars’ (i.e. graduate student or post-doctoral fellow) existing educational program preparation with AVA’s world-class, innovative focus on training to transform population (community) health and social services, specifically to improve the health of girls, women, and gender-diverse people exposed to adverse childhood experiences (ACEs) and violence.
1.Your name (First, Last)(Required.)
2.Your preferred pronouns?
3.What type of scholar are you?(Required.)
4.Please tell us about yourself.(Required.)
5.How did you hear about the AVA Triadic Mentorship program (please write yes beside your selection unless asked to specify)
6.Do you require us to support with matching you to mentors (i.e. academic mentor and/or community agency mentor), or do you have all/parts of a triad established?  Check all that apply.(Required.)