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Mentee Form

Name *

(Please enter your full name)

Title

Please select one from the list

Job Title

Institution

(Please enter your employer’s name and any other institutions that you are affiliated with)

Phone

(Please enter your best contact number)

Email *

(Please enter your current work email)

Research Area

(Please enter your research area of interest)

Research Experience *

(Please enter brief details on the research experience you have to date)

Mentee Experience *

(Please give some details on any previous experience you have, if any, on being a mentee)

Mentee Goals *

(Please explain what you hope to gain from signing up to become a mentee – what are the goals you wish to achieve?)

Contact Preference *

Email
Phone
In Person
Virtual

Commitment

(Please enter how much time you can commit to this scheme – a minimum of 2 hours per month is recommended)

Other Schemes

Please list the other mentoring schemes you are part of (if any)

How did you hear about us? *

By submitting this form, I confirm that I understand the commitments required as a mentee for this scheme and that I will be contacted once a suitable mentor has been identified. *

I agree

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Mentee Form