Are you new to the ASRM Annual Meeting?

First-time Annual Meeting attendees can participate in ASRM’s mentoring program and get paired with a mentor who is an established member of ASRM, has attended several previous ASRM Annual Meetings and often has served in faculty or leadership positions with ASRM.

The Annual Meeting Mentoring Program offers a voluntary, informal relationship between mentors and mentees. We will match mentors and mentees based on practice information, professional interests, desired time commitment and previous involvement with ASRM.

If you are a new member of ASRM, have never before attended an ASRM Annual Meeting, or simply would like to be paired with a mentor who can help you network and navigate ASRM’s 2013 Annual Meeting, please complete and submit the application form below no later than August 15th. Please note that mentoring slots are limited, and mentees will be paired on a first-come, first-served basis. 

Questions? If you need more information about the Annual Meeting Mentoring Program, please contact Jaclyn Decker at jdecker@asrm.org or (205) 978-2000, ext. 134.
 

Full Name: 
 

ASRM ID: 
 

Street Address: 
   

City: 
    

State: 
    

Zip: 
 

Phone: 
 

Email: 

 

Preferred Method of Contact:   

                                     

Profession: 

                                   

Practice Specialty: 

                      

Are you willing to be paired with a mentor who is not in your specialized field?

 

 

Spoken Languages:   

 

Please briefly describe how you would benefit from having a mentor at the 2012 Annual Meeting:   
 
 

Which of the following best describes the time you are willing to commit to being mentored at the Annual Meeting? (This will help us match you with a mentor based on program expectations.) 

                                             

 

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