HOME
- Inbox
WHO WE ARE
DOCUMENTS
APPLICANTS
TRAINING RESOURCES
MEMBERSHIP
MEMBERS ONLY

HOME
- Inbox
WHO WE ARE
DOCUMENTS
APPLICANTS
TRAINING RESOURCES
MEMBERSHIP
MEMBERS ONLY

Home
//
APPCN-TCN Mentorship Program
//
Mentor Application

APPCN-TCN Mentorship Program

Mentor Application

Thank you for your interest in the APPCN-TCN Mentorship Program! Please complete this survey to submit your application to become a mentor.

Please note: a Mentor must be APPCN faculty and/or board certified in clinical neuropsychology.

Instagram

This field is for validation purposes and should be left unchanged.

Personal Information

The following questions are intended to gather information about you, including your contact information, current position, and primary responsibilities.

Name(Required)

First Last

Preferred Email(Required)

Please provide your current position title.(Required)

Please provide your current affiliation.(Required)

Are you a current faculty member of an APPCN postdoctoral program?(Required)

Yes

No

Are you board certified in clinical neuropsychology through ABCN?(Required)

Yes

No

Thank you for your interest in the APPCN-TCN Mentorship Program. Currently, mentors must be APPCN faculty and/or board certified in clinical neuropsychology through ABCN. Please contact appcn.tcn.mentorship@gmail.com with questions.

Please select your current workplace setting.(Required)

Academic Medical Center (AMC)

Veterans Affairs (VA) Medical Center

Private Hospital

Private Practice

Other

Please describe your current responsibilities.(Required)

Check all that apply.

Clinical

Research

Supervision

Teaching

Administration

Leadership

Years of independent practice(Required)

<1-5

5-10

10-15

>15

Primary population(s) of interest(Required)

Check all that apply.

Pediatric

Adult

Forensic

Geriatric

Other

Other(Required)

Manuscript Review Experience

The following questions are intended to understand your experience reviewing manuscripts and supervision of trainees on the peer-review process.

Approximately how many manuscripts do you review per year?(Required)

0 manuscripts

<1-3 manuscripts

5-10 manuscripts

>10 manuscripts

Have you previously held or currently hold an editor role?(Required)

Yes

No

Do you have experience supervising/mentoring trainees in the peer-review process?(Required)

Yes

No

What level of trainees do you typically supervise in providing peer reviews?(Required)

Check all that apply.

Externship/Practicum

Internship

Postdoctoral

Do you have an active account with ScholarOne?(Required)

Yes

No

Have you reviewed for The Clinical Neuropsychologist (TCN)?(Required)

Yes

No

What other journals have you reviewed for?

Please provide a few "key terms" to identify your research areas of interest/expertise (e.g., dementia, TBI, MCI, forensic, PVT).(Required)

Additional Research Experience

The following questions are aimed to gather your general research experience.

Approximately how many research publications do you have?(Required)

<5

5-10

10-20

>20

How many manuscripts have you published over the past three years?(Required)

None

1-2

3-5

>5

This field is hidden when viewing the form

Mentorship

This field is hidden when viewing the form

Mentor is Available

This field is hidden when viewing the form

Mentor is Matched

This field is hidden when viewing the form

Additional Notes

Are you ready to move forward in the field of Neuropsychology?

JOIN APPCN TODAY

LATEST NEWS

COVID-19 Resources

RESOURCES

Member Directory
Applicants FAQ

JOIN US TODAY

How to Join
Training Directors FAQ

Home
Join APPCN
Directory
Contact Us

Home
Join APPCN
Directory
Contact Us

Facebook-f

Scroll to Top