Mentoring Story- Year Long

Tell us about how MentorSHPE at your local chapter, region, National Convention, or the online platform has made a difference in your life! These testimonies are used to promote the program on our social accounts, provide program impact to partners, and to help recruit new members who need a personal nudge to join.

Name *

First Name Last Name(s)

Email *

example@example.com

Are you a mentor or mentee in the mentoring connection you're sharing about in this form? *

Mentor Mentee

What is your memberSHPE type? *

Junior (K-12) Student (Undergraduate) Student (Graduate) Recent Graduate Professional Associate Lifetime Not currently an active member

What is your SHPE region

1 2 3 4 5 6 7 N/A

What is your SHPE chapter

Type N/A if you're not an active member

What is your highest degree or level of education completed?

Middle School Some High School High School Diploma or GED Some college, no degree Professional/Technical Certificate or Diploma Associate's degree Bachelor's degree Graduate or Professional degree Ph.D.

I identify as

American Indian or Alaskan Native Asian Black or African American Hispanic or LatinX Native Hawaiian or Pacific Islander Two or more races White (not Hispanic/LatinX) Other

I identify as

Female Male Third gender, non-binary Your Mentee/Mentor Information

We want to hear as much information as you have to share about your MentorSHPE experience! Remember, that the greater detail you provide, the more likely you are to be highlighted in our Social Media and website!

My first time engaging in mentorship of any kind was.. *

This is my first mentorship experience Before high school High school Undergrad Graduate School Through an employer Through a professional network

This is my ___ MentorSHPE experience (A MentorSHPE experience is participating in mentoring with a fellow SHPE member via MentorSHPE mentoring platform or app, your local chapter, etc) *

First Second Third Fourth or more

The MentorSHPE experience I am highlighting here started by *

MentorSHPE Mentoring Platform or App Chapter event/program Regional event/program SHPE National event/program Other

Please briefly describe your MentorSHPE experience.

What are the benefits of your MentorSHPE relationship?

What difference did MentorSHPE make in your life?

What makes mentoring through SHPE different is...

Please provide a photo of what your MentorSHPE experience looks like. This can be a screenshot of a video call, your headshot, a MentorSHPE session at your local chapter, your MentorSHPE curriculum and goal outline, or a photo of your success as a result of MentorSHPE.

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Do we have your permission to use your name and image (if you shared one) for promotion of the MentorSHPE program? *

Yes No

What social media handles would you like SHPE to tag you in if your story is selected?

Would you like to participate in a virtual MentorSHPE panel?

Yes No

Your Information