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Mentoring Workshop Application

Application for CSWEP Mentoring Workshop (CeMent) at the Western Economic Association Meetings in San Diego, CA, June 23 and 24, 2017



Name and Contact Information



First Name


Last Name


Postal Address


E-mail address


Phone:


Cell phone:


Are you
Female
Male

Professional Employment



Have you applied to the CeMENT workshop in a prior year?
Yes
No

Have you completed your Ph.D.?
Yes
No

In what year did you receive or do you expect to receive your Ph.D.?


Name of Ph.D. institution:


Name of your current institution of employment:


In which department(s) are you appointed?


What is the highest degree offered by your department?
Bachelors
Masters
Ph.D.
no degree offered

What is your job title?
Assistant Professor
Associate Professor (without tenure)
Other

In what month did you begin this position?


In what year did you begin this position?


Does your current institution consider you to be employed
part-time
full-time

What is your tenure status at this institution?
Tenured
On tenure track but not tenured
Not on tenure track although the institution has a tenure system
No tenure system at this institution

In what year do you expect to be evaluated for tenure? If not in a tenurable position, please respond "N/A."


What is your primary area of research?


What is your secondary area of research, if any?


What is the standard teaching load in your department per year? (Please indicate semester or quarter courses.)


In the order that best matches your teaching interests, please list the courses that you have taught in the last 5 years.


If you were to assess tenure decisions at your institution, to what extent are these based on teaching, research, and service?  Provide a percentage estimate for each category below.



Teaching:


Research:


Service:


Personal Information




Single never married
Married
Living with a partner
Separated or divorced or widowed
Other

If married or living with a partner, what is the highest level of education of your spouse or partner?
High School
Associate or Vocational Degree
Bachelors Degree
Masters Degree
Doctorate

If married or living with a partner, is your partner employed in a professional position at an institution of higher education?
No
Yes--at this institution
Yes--at another institution of higher education

Do you have children?
Yes
No

If yes, please list the ages of your children.


Do you currently have someone whom you would consider a mentor?
Yes
No

If yes, is this person in your department?
Yes
No

If yes, is this person
Female
Male

Do you currently anticipate being in an academic position in 10 years time?
Yes
No

Submit this survey to complete this part of the application.  Then e-mail the following information to  aowen@hamilton.edu by December 1, 2016.  The files should be included as attachments in the e-mail in pdf format.  The subject line on the e-mail should read:  Firstname Lastname CeMENT application.

  1. A c.v. which includes the date your received your Ph.D., your research and teaching area, and your current position.  Label the file as lastname_cv.
  2. In 500 words or less describe your teaching and research interests and goals.  Label the file as lastname_interests.