If the form does not work - Please answer the information below and reply:
Internship Mentor/Mentee Program
1. First and Last Name *
2. Email *
3. Phone number
4. I have read and understood the mentoring booklet (yes or no)
5. Please describe what your interest/area of concentration is for being an RD (list as many as apply!)
Clinical nutrition, Community nutrition, Foodservice, Private practice, Sports nutrition, Eating disorders, Intuitive eating/health at every size, Obesity and weight management, Pediatric nutrition, Geriatric nutrition Other:
6. What kind of program are you interested in on-site, distance, or both?
7. What would you like to take away from this mentorship program?
8. Availability for meeting with mentors.
9. We are making an effort to promote diversity in dietetics - the following questions are optional.
- What is your ethnicity?
- Would you like to be paired with a mentor based on your ethnicity?
Thanks so much!