CRBLM Mentorship Program Registration (winter 2020)

Email address *

First name *

Your answer

Last name *

Your answer

Membership status *

Graduate member (Master's student)

Graduate member (PhD student)

Postdoctoral member

Research associate member

Regular member

Collaborating member

Other:

Affiliation *

McGill University

Université de Montréal

Université du Québec à Montréal

Concordia

Department/school

Your answer

If you are a STUDENT, a POSTDOC, or a RESEARCH ASSOCIATE please write the name of your supervisor

Your answer

Would you like to be a mentor or a mentee? *

Mentor

Mentee

Both (we will try to pair you twice)

Required

Have you participated in the CRBLM's previous mentorship rounds? *

Yes

If you participated in our previous mentorship rounds, who were you paired with?

Your answer

Preferred language

French

English

No preference

What are your expectations of the mentorship program?

Your answer

Additional comments

Your answer

A copy of your responses will be emailed to the address you provided.

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