Miller School of Medicine - Mentor Sign Up
When you click Submit (at the bottom of this web page) it will save your
information on the server for us.
The information is due by 4/28 at 5:00PM.
TAB OR USE THE MOUSE Between the
Answer the questions as best you can. The boxes will expand as you type if you need more space.
(Don't worry if it is a one word answer. The box size is standard.)
(Type carefully and completely, if
you are chosen this will be the address your mentor will use to contact you.)
What do you hope to get out of a relationship with a Miller School of
Medicine medical student mentor?
If for whatever technical reason this form does not return a "Thank you",
email the information to me at the above address and I will add it to the file