Peer Mentor Sign-Up
Please complete the form & sign at the end to indicate your interest in becoming a peer mentor.
Student Name
*
First Name
Middle Name
Last Name
Age
*
Student E-mail
*
first.last.23@tmsu.edu.vc
Mobile Phone Number
*
What year of study/term are you currently?
*
Clinical - Core Rotations
Clinical - Dedicated Step 2 Study
Clinical - Elective Rotations
Clinical - Post Elective Rotation, awaiting match 2024
Other
Hometown/Country
*
How many Mentees are you willing to have?
*
One
Two
Three
Other
Hobbies/ Interests outside of medicine
*
Speciality of Interest
Emergency Medicine, OBGYN, Surgery, Etc.
Transfer Students Only: Please indicate which school you transferred from, if you wish to potentially be matched with a transfer student from the same school. Please also indicate your starting term with Trinity.
Additional Comments
Submit Application
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