CU AMSA: Women in Medicine Mentoring Program Application 2012
School and Year:
Cell phone number:
Have you participated in the mentoring program before? If so, who was the physician you were paired with?
Short Answer Questions:
Please list the top 3 specialties you are most interested in and explain why. We will do our best to match you with a doctor in your specialty of interest. If you do not have a preference, please indicate this as well.
What is your availability for shadowing (ie. winter break, spring break, Fridays, etc)?
What do you want to gain most from this mentoring and shadowing experience?