AIHC Mentoring Program - Mentee Application

Apply to be mentored by an experienced AIHC member!

The American Interprofessional Health Collaborative and the National Center for Interprofessional Practice and Education invite applicants who are interested in being mentored by an experienced AIHC member Details about the program, criteria for applicants, and requirements for participants selected can be found here.

Email Address

Are you a current AIHC member? You must be a current AIHC member in order to apply.

Yes

Name:

First

Last

Degrees and credentials listed after your name (e.g. MD, RN, MPH, etc.):

Current institution of employment:

City and State (e.g. Los Angeles, California):

Time Zone:

Eastern

Central

Mountain

Pacific

Other…

Professional Affiliation (e.g. Dentistry, Health Administration, Occupational Therapy, etc.)

How does your experience demonstrate a commitment to interprofessional practice, education, and/or scholarship? (~200 words)

Describe the most pressing issue that you would like a mentor to help you address in the next year.

What do you see as the most pressing needs in interprofessional practice and education?

Briefly state your primary goals if you are chosen to participate. (~200 words)

Please upload your CV or resume.

Upload requirements