Application

Senior Scholar Willing to be a Mentor

Commission on the Status of Women (AEJMC) Mentoring Project
[Note: Information on this form will only be shared by the two administrators of the AEJMC Mentoring Project.]

Name _______________________________________________________________________ University Affiliation ______________________Communication areas____________________ Email ____________________________________ Telephone __________________________ Academic status:
____ ____ ____ ____ Associate Professor Full Professor Professor Emerita(us) Other _________________________

Demographics:
Nationality: _______________________________________ Race/ethnicity: ______________________________________ Age: _________________________ Gender: ___ Female ____ Male Other (e.g., physical ability, sexual orientation):

____________________________________ Kind of mentoring you are willing to do: (check all that apply):
____ ____ ____ ____ ____ Strengthen scholarship Strengthen teaching Evaluate strengths and weaknesses Strategize for job search Talk about tenure ____ ____ ____ ____ ____ Consider career path Talk about promotion Deal with a specific situation Adjust to (non)diverse campus environment Other __________________________

Attributes and experiences you especially seek in a mentee (check all that apply):
____ ____ ____ ____ ____ ____ ____ ____ ___ ____ Is an asst./assoc. professor Is a graduate student has strong scholarly promise Is a woman of color (specify: ______) Is a White woman Is close to my age Is younger than I am Seeks an administrative post Is confronting sexual harassment Is married/has been married ____ ____ ____ ____ ____ ____ ____ ____ Has children Is single Is a sexual minority Seeks leadership in AEJMC Is at an HBCU or minority-serving campus Is at a majority campus Has the same comm. specialty as me Other __________________

Willing to commit to (check all that apply):

___ ____ ____ one phone call/month ___ two phone calls/month ___ three phone calls/month will review job application drafts, or other materials on an occasional basis Other _________________________________________________________________

Please return form by email either to Tracy Everbach, Everbach@unt.edu, or Frances Ward-Johnson, fward2@elon.edu, by October 25, 2013.