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One-on-One Mentorship Registration Form
One-on-One Mentorship Registration Form
TAMIKA HAYNES
2021-09-10T18:16:52+00:00
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)
Small
Medium
Large
X-Large
2X-Large
As a token of our appreciation, you will receive a t-shirt from the scholar team.
Attending School/University
Degree Type?
(Required)
Ph.D.
DBA
DHA
DIT
DPA
DNP
DrPH
DSW
EdD
Research Proposal Topic?
(Required)
Methodology Selection?
(Required)
Mixed Methods
Qualitative
Quantitative
Do you have your program rubric?
(Required)
Yes
No
Not Sure
(dissertation evaluation checklist or program guide)
Identify your current stage of the doctoral process?
(Required)
Premise Development
Prospectus Development
Proposal Chapter 1 Development
Proposal Chapter 2/Literature Development
Proposal Chapter 3/Methodology
Proposal Chapter 4 or 5/Results
IRB
Doctoral Study: Proposal Section 1
Doctoral Study: Proposal Section 2
Doctoral Study: Proposal Section 3
Identify 1-2 specific areas (chapters/sections) that you would like us to help you complete by the end of the program?
Rate the level of priority of the 1-2 areas that you want to accomplish by the end of the program?
Any additional information you would like to provide?
(Required)
How did you hear about Us?
(Required)
Desired Mentor (1:1 COACHING PROGRAMS ONLY)
Qualitative – Dr. Tamika E. Haynes
Qualitative - Dr. Elizabeth Vargo
Qualitative/Mixed Methods - Dr. Li Ma (Mary)
Qualitative/Mixed Methods - Dr. Travis Hartin
Quantitative (Statistician) - Dr. Lihua Xu
(Your 1:1 dissertation coach is assigned based on your methodology selected above)
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