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STAMP application
Mentee/Mentor Information
1.
Are you interested in being a:
Mentor
Mentee
Both
2.
Full Name
3.
Email address:
4.
Credentials (e.g. MD, PhD, etc.)
5.
Occupation (e.g. physician, occupational therapist, etc.)
6.
Organization / Institution
7.
What area are you interested in getting or receiving support? Check all that apply.
Basic science
Clinical/translational research
Work/life balance
Career development
Other (please specify)
8.
Do you want to include any additional details?
Thank you for your interest in STAMP. We will be in touch to match you up with a complementary mentee/mentor as available/needed.
Questions? Please reach out to info@spartangroup.org.
