One-on-One Mentorship Registration Form

Name(Required)

First Last

Mailing Address(Required)

We will send a welcome package, and gift to the address provided.

Email(Required)

Phone(Required)

T-Shirt Size(Required)

As a token of our appreciation, you will receive a t-shirt from the scholar team.

Attending School/University

Degree Type?(Required)

Area of Study?(Required)

Methodology Selection?(Required)

Do you have your program rubric?(Required)

(dissertation evaluation checklist or program guide)

Identify your current stage of the doctoral process?(Required)

What is your topic under investigation (problem statement)?(Required)

Rate the level of priority of the 1-2 areas that you want to accomplish by the end of the mentorship program?

Identify 1-2 specific areas (chapters/sections) that you would like us to work on with your mentor and complete by the end of your mentorship program?

Any additional information you would like to provide?(Required)

How did you hear about Us?(Required)

Desired Mentor:(Required)

Qualitative – Dr. Tamika E. Haynes

Qualitative/Mixed Methods - Dr. Li Ma (Mary)

Quantitative/Mixed Methods - Dr. Hilda Moses

Quantitative (Statistician) - Dr. Lihua Xu

(Your 1:1 mentor is assigned based on your methodology selected above)