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Mentor Application for Summer Scholars
Mentor Application for Summer Scholars
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Mentor Application for Summer Scholars
2025 Mentor Form for Summer Scholars
You have been listed as a mentor/Primary Investigator (PI) for a CMU College of Medicine student that is applying for the Summer Scholars Program. Please fill out the below information regarding your mentoring of this College of Medicine student. Along with or prior to this form you should have received information about the students project, and bibliography.
Kindly complete this form by March 24th.
Once we have received this form this will complete the students application process.
General Information
Have you mentored previous Summer Scholars within the last three years?
Have you mentored previous Summer Scholars within the last three years?
No
Yes (Provide more information)
Please upload a list of names, presentations, abstracts, and publications that resulted from this work (if need be).
File attachments associated with the ticket.
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Give a description of your role in mentoring and supporting of the applicant/student in the proposed project.
The full details of a ticket, including any appropriate circumstances or supplementary information that may aid in resolving it.
Press Alt + 0 within the editor to access accessibility instructions, or press Alt + F10 to access the menu.
What is the context of this proposed project: Is it part of a larger project? Is it part of your ongoing research work?
Mentor Signature
My signature below certifies that I am nominating the student for a program award, have reviewed the application, project proposal, and bibliography, and agree the submission is the work of the student and meets the grant requirements. I will provide consistent mentoring and support as needed. (Electronic signatures accepted)
Please type your full name as proof of digital signature
Please type todays date as proof of digital signature
Institutional Approvals
Does the work require IACUC, IRB, IBC, or Citi Certification approval? Documentation that required institutional approvals have been obtained
must be provided before funding will be granted.
IACUC:
IACUC:
Not Required
Required, approval attached
Required, seek from student
Required, Pending
Please upload the IACUC Approval Documents in the attachments field above
Please give a brief explanation of why the IACUC is pending
IRB:
IRB:
Not Required
Required, approval attached
Required, seek from student
Required, pending
Please upload the IRBApproval Documents in the attachments field above
Please give a brief explanation of why the IRB is pending
IBC
IBC
Not Required
Required, approval attached
Required, seek from student
Required, pending
Please upload the IBC Approval Documents in the attachments field above
Please give a brief explanation of why the IBC is pending
CITI for Humans?
CITI for Humans?
Not Required
Required, approval attached
Required, seek from student
Required, pending
Please upload the Citi For Human Subjects Approval Documents in the attachments field above
Please give a brief explanation of why the Citi for Human subjects is pending
CITI for Animals?
CITI for Animals?
Not Required
Required, approval attached
Required, seek from student
Required, pending
Please upload the Citi for Animal Subjects Approval Documents in the attachments field above
Please give a brief explanation of why the Citi for Animal Subjects is pending
Thank you for helping with this process!
Your student Summer Scholar application is now complete and will be passed on for judging upon submission of this form. (Please remember to hit "Submit".)
Other Fields
Your name
Your first name
Your last name
Your email address
Verification Code