CIS Foundation: Recognize a Mentor
Is there a mentor who has made a significant impact on your career? Now is your chance to honor them publicly! The CIS Foundation invites you to participate in our Recognize a Mentor program, a heartfelt initiative to celebrate the mentors who have guided us. View additional requirements at https://clinimmsoc.org/CIS/About/Foundation/Recognize-a-Mentor.htm.
Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Mentor Name
*
First Name
Last Name
Mentor Email
example@example.com
Select Your Recognition Level:
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Bronze Level ($25): Recognition on the CIS Website with a statement of up to 50 words.
Silver Level ($50): Recognition on the CIS Website with a statement of up to 100 words.
Gold Level ($100): Recognition on the CIS Website with a photo and a statement of up to 50 words.
Platinum Level ($250): Recognition on the CIS Website with a photo and a statement of unlimited words.
If you have selected a recognition level option that includes a photo, please upload it here:
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I confirm I have made my corresponding donation at https://cis.clinimmsoc.org/forms/donate.php.
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I confirm
Recognition statement (up to 50 words):
0/50
Recognition statement (up to 100 words):
0/100
Recognition statement (unlimited):
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