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2026 OTA Research Mentor Form

2026 Fall Cycle - Volunteer Mentor Application Instructions

This application is intended for the OTA members that are interested in volunteering as Research Mentors for young OTA researchers in order to help them achieve their research career goals.

The Mentor’s job will be to meet with the Mentee, review academic goals and documents, and provide regular feedback at a 12-month period. Each of these tasks is further described below.
1.First and last name(Required.)
2.Email Address(Required.)
3.How many years have you been in practice or held a position following the completion of your training?(Required.)
4.What is your academic rank (if applicable)?
5.Please indicate the area that you are most interested in providing mentorship.(Required.)
6.I commit to reviewing the following documents with my Mentee and providing feedback:

- Mentee will create a one page document outlining 1, 2 and 5 year research goals and how the mentor can best facilitate reaching the goals
- Mentee will provide a CV or Biosketch. If mentee is interested in NIH-funded research they will prepare a NIH-biosketch for mentor to review. Otherwise, CV should be prepared in University/Institute specific format for APT (Advancement Promotion and Tenure)(Required.)
7.Mentor and Mentee will have a preliminary video meeting within 45 days of the assignment to review career goals and biosketch/CV. This meeting should focus on developing concrete 1-year mentorship goals(Required.)
8.Within 30-days of the initial Mentor-Mentee meeting the Mentee will write up a 1-page action plan that both parties will sign and submit to the SRI for records.(Required.)
9.Mentor and Mentee will meet annually at the OTA Annual Meeting or other subspecialty meeting.(Required.)
10.Mentor and Mentee will have at least 3 meetings a year. (Initial set-up meeting, OTA Annual Meeting/other, and year end meeting).(Required.)
11.At the end of the year, the Mentee will provide a 1-year summary to the SRI. Mentee and Mentor can request to continue the relationship through the next year, or to be “re-assigned” to another mentor, or exit the program based on changing needs.(Required.)
12.Please upload your CV. 
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