Mentor for Life After Residency

If you are interested in becoming a mentor for our attendees of the Life After Residency Program, please complete this brief form.

The full Life After Residency program is scheduled for 12-4PM, but the mentorship session takes place from 3:15-4:00PM. Please see event flyer and agenda at https://aapca1.org/events/ (you are welcome to attend the full program!). During the mentorship session, all mentor-mentee groups will join zoom breakout rooms and mentors will conduct a "speed dating" mock interview followed by one-on-one discussion and questions that the mentee may have. We will supply you with some starter questions. Our goal is to pair 1-2 attendees with each mentor and we hope this mentorship pairing will go beyond this program whereas mentees will be able to reach out to you in the future.
1.Full Name(Required.)
2.Email Address(Required.)
3.In what region of the chapter do you primarily practice/reside?
See regions of chapter HERE.
(Required.)
4.Practice Setting:
5.Specialist vs Primary Care (please select one)
6.Where are you in your career?
Thank you for becoming a mentor! Closer to the event, we will pair you with a mentee and send you the live event link. 
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