Diversity Recruitment, Retention & Mentorship

BTP Mentor Diversity Recruitment, Retention and Mentorship Form

Please report on your efforts in Diversity, Equity and Inclusion. Keep in mind your responses should be in the context of the current calendar year. Additionally, please report on your efforts in mentorship trainings.

Faculty Mentor Name
University-Wide Recruitment & Retention
Hosted a minority summer research student
Select all that apply
- Participated in current calendar year
- Planned for upcoming year
Details
Click the + on the right to add another student
Name of student Home university
Presented at a Historically Black College or University or at a Hispanic Serving Institution
Select all that apply. For a list of HBCUs and HSIs, see here and here, respectively.
- Participated in current calendar year
- Planned for upcoming year
Details
Click the + on the right to add another college/university
Name of university Date of presentation
Participated in a National Conference related to increasing diversity (NOBCChE, SACNAS, ABRCMS) or inclusion
Select all that apply.
- Participated in current calendar year
- Planned for upcoming year
Details
Click the + on the right to add another conference
Name of conference Date(s)
Participated in a UW program to increase diversity (CHOPS, Engineering OPPS)
Select all that apply.
- Participated in current calendar year
- Planned for upcoming year
Details
Click the + on the right to add another program
UW program name Date(s)
Served on a University-wide committee related to diversity
Select all that apply.
- Participated in current calendar year
- Planned for upcoming year
Details
Click the + on the right to add another committee
Name of committee Role
Other University-Wide Role or Activity
Select all that apply.
- Participated in current calendar year
- Planned for upcoming year
Details
Click the + on the right to add another activity
Include relevant information
Departmental/Graduate Program-specific Recruitment and Retention
Departmental Diversity Committee
Select all that apply.
- Participated in current calendar year
- Planned for upcoming year
Details
Click the + on the right to add another committee
Name of committee Role
Underrepresented minority group member mentored
Select all that apply.
- Current or during previous 12 months
Details
Click the + on the right to add another mentee
Name Title (undergrad, grad student, postdoc)
Other Department or Graduate Program-specific Role or Activity
Select all that apply.
- Participated in current calendar year
- Planned for upcoming year
Details
Click the + on the right to add another activity
Include relevant information
BTP-specific URM Recruitment & Retention
Shared information about BTP at a conference or event
Select all that apply.
- Participated in current calendar year
- Planned for upcoming year
Details
Click the + on the right to add another activity
Conference/event name Date(s)
Nominated minority student or student with a disability to BTP
Select all that apply.
- Nominated a minority student in current calendar year
Details
Click the + on the right to add another trainee
Name of student
Other BTP specific Role or Activity
Select all that apply.
- Participated in current calendar year
- Planned for upcoming year
Details
Click the + on the right to add another activity
Include relevant information
Campus Mentorship and Diversity Trainings
Participated in NRMN - National Research Mentoring Network
Select all that apply.
- Participated in NRMN in current year
- Planned for NRMN in upcoming year
Participated in WISELI Excellence & Diversity or Breaking the Bias Habit
Select all that apply.
- Participated in WISELI / Breaking Bias in current year
- Planned for WISELI / Breaking Bias in upcoming year
Participated in CIMER (Center for Improvement of Mentored Experiences in Research)
Select all that apply.
- Participated in CIMER in current year
- Participated in CIMER in upcoming year
Participated in Delta Research Mentor Training
Select all that apply.
- Participated in Delta Research Mentor in current year
- Participated in Delta Research Mentor in upcoming year
Other mentorship or diversity trainings
Select all that apply.
- Participated in Other Mentorships / Trainings in current year
- Planned for Other Mentorships / Trainings in upcoming year
Details
Click the + on the right to add another activity
List specific training or activity
Consent*
I understand my information is being used for campus and NIH reporting purpose(s).
Phone
This field is for validation purposes and should be left unchanged.

Name of student	Home university

Name of university	Date of presentation

Name of conference	Date(s)

UW program name	Date(s)

BTP Mentor Diversity Recruitment, Retention and Mentorship Form

University-Wide Recruitment & Retention

Departmental/Graduate Program-specific Recruitment and Retention

BTP-specific URM Recruitment & Retention

Campus Mentorship and Diversity Trainings