Mentor Application Form
Please apply to be a mentor if you are a senior academic in the field of Physics, self-identify as a woman and would like to support and encourage young undergraduate and postgraduate women from around the world.
Email address *
First name *
Your answer
Family name (surname) *
Your answer
Date of Birth *
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DD
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YYYY
Nationality *
Your answer
Country of current residence *
Your answer
University or Institute *
Your answer
Position *
Your answer
Research Field *
Your answer
One paragraph bio for our website (see http://supernovafoundation.org/mentor-bios for examples) *
Your answer
Do you agree to adhere to the Supernova Foundation Code of Conduct (http://supernovafoundation.org/code-of-conduct/)? *
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