Hacking Dermatology Mentor Application
If you are interested in being considered to be a mentor at the Virtual Hacking Dermatology event please complete this application. Applications will be considered on a rolling basis and you will be notified within 2 weeks of your application being submitted.

Dates: October 23-25, 2020
Location: Virtual

Most mentors will commit to being available for teams on the virtual hackathon platform for a minimum of 3 hours on Saturday, Oct. 24 and/or the morning of Sunday, Oct. 25, and will share expertise and guidance with multiple teams. Mentors are encouraged to attend the kickoff portion on Friday, Oct. 23 and the final pitches / award ceremony on Sunday, Oct. 25.

- Teams of 5-6 will be formed at the beginning of the event
- Collaboration will be facilitated via tools such as Zoom, Slack and Google Drive.

If you are interested in being a participant, who joins a team and competes in the hackathon activities, please fill out the participant application (https://forms.gle/VU4Y3iYdhcjmJibX7).
Email address *
First Name *
Last Name *
Credentials *
What is your organization/academic institution affiliation? *
What is your area of expertise, as related to dermatology, precision medicine, digital health, and entrepreneurship? *
What do you think you will best offer to teams in terms of guidance and advice? *
Please provide a link to your LinkedIn profile, online bio, or CV. *
We request that all mentors commit to attending the hackathon for a minimum of 3 hours during the times when teams will be working. All mentors are also welcome to join Friday evening for the kickoff event and Sunday for the final pitches & awards. Can you commit to (please check all that apply, all times listed as ET): *
When you attend the hackathon and/other other related events, you will enter an area where photography, audio, and video recording may be taken and where members of the media may be present to cover the event. By attending this event, you consent to photography, audio, and video recording and its release, publication or reproduction to be used in the future. Do you acknowledge this? *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy