LAHIDAN Mentoring Program
Mentee Sign-up
Name
First Name
Last Name
Academy Member Number
City & State
Phone Number
-
Area Code
Phone Number
Email
example@example.com
What school or program are you enrolled in?
How many more semesters/trimesters do you have left to graduate? (Explain if semesters or trimesters)
Which track(s) would you prefer to be a part of?
Track 1: Internship application - 4 months duration, November-February15th
Track 2: Pre-internship application - 1 year duration (best for students 1-2 years away from applying for the internship)
Track 3: Career development - 1 year duration (best for interns or new professionals with less than 1 year experience)
What particular area in Dietetics are you mist interested in pursuing
clinical
community
food service
private practice
Other
In matching you with a mentor, is there anything else you would like for us to take into account? (Examples: how involved do you want your mentor to be and confirm your willingness to do the necessary work and follow-through)
Track 1 Mentees, please list at least 3 internship you are thinking of applying to
Please attach your resume or cover letter to better understand you career background
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This is not a requirement
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