'Under My Wing' Mentor Application

First

Last

E-mail

Phone Number

Year in Program

Second

Third

Fourth

Fifth

Statements of Understanding: I agree that I am interested in being part of the Under My Wing Mentorship Program in order to receive guidance along with personal and professional development from Mentor pharmacists. I understand that being matched in the Mentorship Program is a year-long commitment of at least one hour in person or on the phone, or video call per month with my mentor. I understand that being part of the Mentorship Program is a privilege which can be revoked at any time, if I do not comply with the minimum requirements or standards set forth by the Mentorship Program. I understand that this is not a job interview for a future employment. I understand that the Mentorship Program does not require me to work in the Mentor’s pharmacy.

Agree