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Application

Seeking a Mentor
UNT Womens Faculty Network Mentoring Project
[Note: The information you enter on this form will be shared only with the person who becomes your mentor.]

Name ____________________________________________________
School/College ______________________ Department ___________________________
Lecturer ________(rank)
Assistant professor
Associate professor
Email ____________________

Telephone _______________

Demographics (optional):

Nationality:
_______________________________________
Race/ethnicity: ______________________________________
Age: ______________________________________________
Other (e.g., physical ability, sexual orientation, etc.) _____________________

Attributes and experiences you seek in a mentor (check all that apply):
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____
____
____

Is an assoc. professor
Is a full professor
Is a senior or principal lecturer
Is a woman of color (specify: ______)

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____
____
____

Is LGBTQ
Has the same specialty as me
No preference on specialty
Other __________________

What motivates you to seek a mentor?


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____
____
____
____
____
____
____
____

Strengthen my scholarship
Strengthen my teaching
Evaluate my strengths and weaknesses
Talk about tenure/promotion
Consider career path
Deal with a specific situation
Adjust to (non)diverse campus environment
Just want general advice
Other __________________________

Do you have someone in mind to serve as your mentor? If so, who?__________________