ACRL STS Sci/Tech Library Mentors Be a Mentor: Volunteer Form

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If you have experience in areas of sci/tech librarianship that you would like to share with others, we encourage you to fill out the form below to join our team!

Contact Information

Name *

Position Title

Work Address

City

State

Zip Code

E-mail

Phone

Fax

	Yes	No
Would you be willing to communicate via phone?	Yes	No
Would you be willing to communicate via e-mail?	Yes	No
Would you be willing to meet with an individual locally?	Yes	No
Would you be willing to meet with an individual at a national conference?	Yes	No

Type of Library

Academic

Special

I am or have previously been responsible for the following subjects/academic departments:

Mentors, please indicated your level of experience in the following areas.

	(None)	1	2	3
Administration/supervising	(None)	1	2	3
Career Development	(None)	1	2	3
Collection Development and/or management	(None)	1	2	3
Conference attendance/networking	(None)	1	2	3
Conference presentations/papers	(None)	1	2	3
Faculty liaison	(None)	1	2	3
Instruction and Information Literacy/Competency	(None)	1	2	3
Library association committee service	(None)	1	2	3
Licensing/consortia	(None)	1	2	3
Poster sessions	(None)	1	2	3
Publicity/outreach	(None)	1	2	3
Publishing	(None)	1	2	3
Science Reference	(None)	1	2	3
Web design	(None)	1	2	3

1 = Minimally experienced, 2 = Somewhat experienced, 3 = Very experienced.

Please list any other areas of experience you feel are relevant.

My other areas of responsibility include:

My research interests (if any) include:

My special technical or research skills include:

(such as web design, interactive tutorial design, survey creation, usability study design, etc.)

How many mentees are you willing to mentor simultaneously?

Do you have any specific expectations of the program itself? Why do you want to be a mentor?

Is there anything else we should know about your experience or goals that might help us match you with potential mentees?

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