Medical Education Resources
Initiative for Teens
Baltimore, Maryland
Leadership@MERITBaltimore.org
www.MERITBaltimore.org
Fall 2015 Mentor Application
MERIT is a non-profit organization that partners with local universities and hospitals to transform Baltimore City high
school students into Baltimore’s health care leaders. We provide three levels of support for three years including weekly
Saturday sessions, paid summer internships, and longitudinal mentoring. Our Scholars are accepted into the program after
a rigorous application process. This year, we are expecting 120 Scholar applications for 30 spots, so the chosen MERIT
Scholars will be truly spectacular high school students willing to work hard to achieve their goals. They just need extra
support from someone like you!
Mentor Responsibilities: The MERIT mentor team will serve as a social, emotional, and professional support system
for a cohort of MERIT Scholars. Mentors will act as Scholars’ emotional and personal safety net, individualize Scholars’
MERIT experiences, illuminate the path to Scholars’ career goals, monitor Scholars’ academic progress, and connect
Scholars with networking and enrichment opportunities in the city. At a typical meeting, MERIT mentors may be leading
a small group discussion about institutional racism and the connection to health care disparities, personal and professional
goal setting, or the different steps on the journey to becoming a health professional.
Time Commitment: MERIT mentors receive professional development and spend time with their Scholars for 3-4
hours one Saturday a month. Additionally, mentors are expected to communicate and meet with Scholars outside of the
monthly sessions. The total time commitment is 5-7 hours a month. Mentorship is a 1.5-year commitment (through May
2017) with the option for an additional two-year commitment, as a college support coach.
Eligibility: Mentors must live in Baltimore until at least May 2017. A mentor can be an undergraduate, graduate student
or working professional, but ideally he or she is planning to pursue a career in a health-related field (medicine, nursing,
public health, pharmacy, dentistry, social work, etc.).
Application Process
We suggest that you work on your application in this document. When you have finalized your responses, please email this
document as an attachment to Leadership@meritbaltimore.org Please also include an updated resume.
Before submitting, check to make sure you have completed these tasks:
� Ensure that you are eligible to apply to be a mentor by reading the information above. If you can anticipate that you
will not be able to honor the monthly time commitment, please describe why:
� Check to make sure your email has two attachments: 1) completed application, 2) updated resume
� Mark the relevant interview date(s) on your calendar:
PRIORITY DEADLINE INTERVIEW: Saturday, November 7 from 10 a.m. to 1 p.m.
REGULAR DEADLINE INTERVIEW: Saturday, January 9 from 10 a.m. to 1 p.m.
� Electronically sign the application acknowledging your obligation to complete the MERIT program if selected.
PRIORITY APPLICATION DEADLINE: OCTOBER 25, 5:00 pm
REGULAR APPLICATION DEADLINE: DECEMBER 13, 5:00 pm
2
Section 1 – Personal Information
Full Name:
Hometown:
Phone Number:
Email:
Gender Identity:
Racial/Ethnic Identity:
Did either of your parents
graduate from college?
Were you eligible to receive
free/reduced meals during high
school?
How long do you plan to live in
Baltimore?
Section 2 – Education
Name of Current School or
Employer:
Current Degree Program or
Position Title:
Intended Year of Graduation:
(students only)
Undergraduate Major(s) and
Minor(s):
Undergraduate GPA:
Other Relevant
Education/Graduate Degrees:
Graduate GPA:
Career Goal:
Section 3 – Short Answers
Why do you want to be a MERIT
mentor?
Please limit your response to 150
words.
3
What strengths, skills, mindsets,
and experiences do you possess
that would make you an excellent
MERIT mentor?
Please limit your response to 150
words.
MERIT Scholars are either 1)
from low-income families,
and/or 2) first-generation college
students. What experiences have
you had working with similar
populations and what have you
learned from them?
Please limit your response to 150
words.
MERIT Scholars are committed
to reducing health care disparities
and improving the health of
Baltimore city. Describe your
personal commitment to reducing
health inequities.
Please limit your response to 150
words.
MERIT mentors model
excellence in: impactful
leadership, innovative thinking,
overcoming adversity, and
achieving their goals. Direct us to
two activities or accomplishments
on your resume that exhibit these
characteristics and describe why
you are most proud of them.
Please limit your response to 250
words.
Baltimore City is an
underperforming school district.
What role do you think
mentorship can play in helping
MERIT Scholars succeed
academically in under-performing
schools?
Please limit your response to 150
words.
4
Research has shown that underrepresented minority students
often experience negative
thoughts around two themes:
belonging and ability, as discussed
by Paul Tough in Who Gets to
Graduate. How could you
provide support to a MERIT
Scholar who might have similar
thoughts about their aspirations of
entering the health professions?
Please limit your response to 150
words.
Section 4 – Disclosure of Misconduct
Have you ever been charged with
any crime or received a criminal
citation, regardless of the
outcome?
If yes, please explain fully:
Section 5 - Mentor Commitment & General Release
I have read the background information outlining the mentor’s role, and I confirm I am eligible to apply to become a MERIT
Mentor. I certify that all the information in this application is true and accurate. If I am selected to be a MERIT Mentor, I
commit to fulfilling all MERIT mentor requirements as detailed through May 2017, including attending one in-person
session per month on a Saturday morning. I give my consent for MERIT to release my name and likeness to partner
organizations and for use on the MERIT website.
Applicant Signature
Date:
Section 7- Next Steps and Interview Dates
You will receive a confirmation of your application submission and you will also be notified if you have been selected for an
interview. Until then, please save the relevant interview date in your calendar, as listed at the beginning of this application.
If you have a conflict with this date, please describe the situation below. We will do the best we can to accommodate your
needs.
Thank you for applying to become a MERIT mentor! We are excited you have decided to join us
as we transform Baltimore City high school students into Baltimore’s health care leaders. Mentors are a
key component to the support MERIT provides its Scholars, and we cannot do this without you.