First name:

Middle name (optional):

Last name:

Telephone number:

E-mail address:

Current mailing address:

Permanent mailing address:

Gender:

Date of birth in YYYY/MM/DD format:

Diversity

Instars seeks to include Mentors of diverse backgrounds.  Please indicate if you belong to any of the following groups:

Race or ethnicity: Select Race or Ethnicity Black/African American Hispanic/Latino Native American/Alaskan Native Native Hawaiian/other Pacific Islander Asian American Indian American Other (please specify below)

If you selected "other" for race or ethnicity, please specify (limit 256 characters):

Disability, please specify:

Any other qualifying groups (e.g., First-Generation College Student) (limit 256 characters):

Applicant History

Have you been to a SFS meeting?
Select yes or no Yes No

      If yes, what year(s):

Have you participated in the Instars Program as a Fellow? Select yes or no Yes No

      If yes, what year(s):

Have you participated in the Instars Program as a Mentor? Select yes or no Yes No

      If yes, what year(s):

Academic Information

Academic Institution:

Other Academic Institution:

Major or Program & Degree (e.g., M.S. Ecology, Ph.D. Entomology):

Expected Graduation Date:

Mentoring Statement

Mentoring Statement: Provide a brief statement (12pt Times New Roman, single spaced, 1 page maximum) indicating how your involvement in the Instars Program will help you achieve your long-term career goals while meeting the mission of the program and the SFS to increase diversity in the freshwater sciences. If you were previously an Instars fellow, include some details of your experience and how your experience as a mentor will be different than as a fellow. If you have been a mentor for Instars or another program, please talk about your previous mentoring experience and how you will build upon it as an Instars Mentor.

Submit the file in PDF format and name your file as
Lastname_Firstname_Transcript.pdf

Only pdf files can be uploaded, any other file type will result in an error.