Recruitment and Science Outreach, University of Texas Health Science Center at San Antonio

UTHSCSA Faculty and Staff interested in becoming Mentors can please fill out the form below. Dr. Chapa will be in contact as soon as a student mentee has been assigned.

Name of contact person:

Department/Organization:

Phone: Fax: E-mail:

I would like to be a mentor in the:
Collegiate Volunteer Program for pre-professional students
Cyber-Mentor Program for Med Ed Program students
Health Careers Clinical Investigation Program

Volunteer activities (please check all that apply):
Clinical observation
Hands-on activities
Administrative assistance (filing, typing)
Laboratory work

Please indicate how many students you would like to mentor:

If interested in the Collegiate Program, please list the days and times you are available to provide mentorship:

Please provide a short description of your program and/or field of study:

Mentor Membership Form