Mentor Registration

Mentor Registration Form
City
State/Province
Zip/Postal
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Preferred Mentor Structure

Areas of Expertise

Other Comments/Needs

Agreement

If placed in a mentoring relationship, I will adhere to the following expectations:
- Mentors and mentees will respect the boundaries (number, timing of contacts, length of relationship) established in the initial plans agreed upon by both parties unless modified by mutual consent.
- Mentors and mentees will adhere to the IAPHS Code of Conduct in their relationship.
- Problems, withdrawals, or significant changes to the initial plan will be reported to Suzanne Bevan,
- IAPHS Administrative Director, sbevan@iaphs.org. IAPHS reserves the right to withdraw its support for any pair that violates expectations.