Healthcare Bigs – For Potential Mentors

Greetings health professions students! We are so glad that you are interested in being a mentor! If questions arise as you complete the application below, please do not hesitate to get in touch (kloney83@ewu.edu or 509-828-1381).

Healthcare Bigs Mentor Form

Application form for potential mentors to participate in Healthcare Bigs and Littles

Name * Required
First Last
Address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email * Required
Phone * Required
Which university are you currently enrolled in? * Required
- EWU
- SCC
- UW
- Whitworth
- WSU
Which health professions program are you currently enrolled in? * Required
Why are you interested in being a mentor? * Required
It is the hope of the EWAHEC that students are willing to be matched with any high school student. If you have preferences on what type of student you are matched with, please list them here (ie. geographic area, etc.) * Required
Mentor Responsibilities
By typing my initials in this box, I understand that I am subject to a background check. This will be at no cost to me. * Required
By typing my initials in this box, I understand that the Healthcare Bigs and Littles Mentorship program is a volunteer opportunity for which I will receive no compensation and am considered a volunteer, and must complete an EWU Volunteer Form. * Required
By typing my initials in this box, I understand that any student organization of which I am a member is entitled to $50 if I am matched to a mentee. I also understand that it is my responsibility to notify the student organization to contact the EWAHEC to receive this money. * Required
By typing my initials in this box, I understand that I am responsible for attending a training that lasts up to 2 hours on effective mentorship and best practices. * Required
By typing my initials in this box, I understand that it is my responsibility to schedule a monthly Zoom call with my mentee using the Bigs and Littles Zoom account. * Required
By typing my initials in this box, I understand that I may have to attend on-going mentorship training as required by the EWAHEC and that this training will be online and can be completed on my own time. * Required
By typing my initials in this box, I understand that I am responsible for attending the year-end party in May or June of 2020 to meet my mentee. * Required

Healthcare Bigs Mentor Form

Mentor Responsibilities