Research Mentor Form

Personal Information

Name *

First

Last

Email *

Phone Number

City

Country

LinkedIn Profile or Professional Website

Professional Background

Number Specialization Expertise

Current Position/Title

Organization/Institution

Highest Degree Earned

Area of Specialization

Years of Professional ExperienceLess than a year1234567891010+

Expertise and Interests

Primary Field(s) of Expertise (Select all that apply):

• Engineering and Technology
• Business and Economics
• Environmental Science
• Arts and Humanities
• Healthcare and Medicine
• Social Sciences
• Other (Please Specify)

Please Specify Primary Field of Expertise:

Areas of Interest for Mentorship (Select all that apply):

• Research Guidance
• Career Counseling
• Academic Writing and Publishing
• Project Development
• Other (Please Specify):

Areas of Interest for Mentorship:

Preferred Mode of Engagement

• Online (Webinars, Virtual Meetings)
• In-person (Workshops, Seminars)
• Both

How much time can you dedicate to mentorship per month?

• 1-5 hours
• 5-10 hours
• 10+ hours

Would you be open to participating in group mentorship sessions or panel discussions?

• Yes
• No

Do you have any specific projects, ideas, or topics you'd like to mentor on?

• No
• Yes (Please provide details)

Projects, ideas, or topics you'd like to mentor

Supporting Documents

Upload Your Resume or CV *

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Upload Additional Supporting Documents or Publications

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Agreement

• I confirm that all the information provided is accurate to the best of my knowledge.

• I agree to adhere to the guidelines and code of conduct for Research Mentors

Submit Your Application