Mentor Sign-Up Form

HPM Alumni Mentor Program Sign-Up Form

Please fill out the form below to participate as an alumni mentor. If you participated as a mentor last year and would like to participate again this year, please fill out this new form as you will be matched with a new student. Be sure to select all industries you may have experience in to better assist us with the matching process. You should expect an email matching you with your mentee(s) in early October. Please email Becca Schoenfeld with any questions or concerns: rs3665@cumc.columbia.edu
Name:*

First NameLast Name
Degree*
Graduation Year*
Number of Years Work Experience*
Job Title*
Company*
Industry*

Administrative FellowshipBiotechCommunity HealthConsultingEntrepreneurship/Start-upEnvironmental HealthFemTechFinanceFood PolicyFoundationGlobal HealthGovernmentHealth CommunicationsHealth ITHealthcare TechHospital AdministrationHRInnovationInsuranceMarketingMedical DevicesMedical ResearchMedicineMental HealthNon-profitPharmaPolicyPublic Health LawReproductive HealthThink TankUniversityUrban HealthVenture CapitalOther
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Preferred Phone *
Phone Number*

Area CodePhone Number
Do you feel comfortable mentoring more than one student?*

YesNo
Did you complete an administrative fellowship?*

YesNo
Over 30% of HPM students are international. It is helpful to hear from mentors who have experience navigating graduate school and working in the US. Please check "yes" if you share this experience and are comfortable sharing your expertise with a mentee.*

YesNo
If yes, please indicate your home country.
URL to LinkedIn or bio page
Would you like to participate in mock interviews?*

YesNo
Are you interested in hosting a student for a summer APEx (formerly known as practicum)?*

YesNo
Should be Empty:

HPM Alumni Mentor Program Sign-Up Form