Rematriation: Womxn in STEM Leadership Mentorship Form

Our team appreciates your participation in our Rematriation: Indigenous Womxn in STEM Leadership project.

Please email Dr. Tiffany Smith (she/her), AISES director of research and career support, at tsmith@aises.org for any further information or questions.

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* 1. Please leave your contact information below.

Name

Email Address

Phone Number

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* 2. What is your Tribal Affiliation(s)?

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* 3. Current City (City, State)

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* 4. Are you interested in being a mentor or mentee?

Mentor

Mentee

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* 5. Professional Industry

Academia

Entrepreneurship

Government

Non-Profit

Private Industry

Other (please specify)

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* 6. Please indicate your current career stage:

Exploration (Pre-workforce)

New Professional (0-5 years in workforce)

Establishment (5-15 years in workforce)

Mid-Level (15-25 years in workforce)

Late Career (25+ years in workforce)

Pre-Retirement (0-10 years pre-retirement)

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* 7. Company Size

Micro (0-6)

Small (7-250)

Medium (51-500)

Large (501-1000)

Enterprise (1001+)

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* 8. My typical work environment is:

Remote

Hybrid

In-Office