Your Name
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First Name
Last Name
Describe your latest internship in moderate detail
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4-8 sentences about what you did, why it mattered, whether you enjoyed it, how much freedom/ownership you had.
Was your internship remote, hybrid, or in person?
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In Person
Remote
Hybrid
Where is your mentor located (even if your internship was remote)?
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How often did you meet with your mentor?
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Once a month
Several times per month
Once a week
Several times per week
Every day
Several times per day
Less than once per month
Did you qualify for WESEF using the research from your internship?
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Yes
No
What competition category did you compete in
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Were you given the opportunity to contribute to research intended for publishing?
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Yes, and I was published
Yes, but I was not published
No
My mentor has granted me permission to share their name and information in order to become a Pelham Science Research Connection.
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Please be sure to fill out this form regardless. Mentor info will not be shared if they did not grant permission.
Yes
No
Mentor's Name
*
First Name
Last Name
Mentor's Email
*
About the Mentor
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2-4 sentences describing the mentor's background and work (Education, job, recent topics of interest, etc.)
Field/Category of Mentor's Work
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Select up to 3 categories that apply to the mentor's work, as appropriate
Astronomy
Behavioral Sciences
Cellular and Microbiology
Chemistry
Computer Science
Engineering and Physics
Environmental/Animal/Plant Sciences
Materials Science
Mathematics and Statistics
Medicine and Health
DID NOT RECEIVE PERMISSION
Mentor Attributes
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Select UP TO FIVE that best describe your mentor's skillsets or personality.
Expert in their field
Strong Communicator
Values Intern Input
Patient
Approachable
Critical Thinker
Organized
Strong Time Management
Encourages Networking
Encourages Teamwork
Academic Writing
Data Analysis
Creative
Good Teacher
Good Motivator
Very Involved in Intern Work
Less Involved in Intern Work
Good Presenter
Values Getting Published
Innovative
Relaxed
DID NOT RECEIVE PERMISSION