Mentee survey
Welcome to the Global OHNS Mentoring Program. We would like to learn more about you and your research interests. 
Email *
Complete Name *
Have you finished your bachelor's degree? *
What is your current level of training? *
Please specify any other type of training. *
Are you a medical student? *
If yes, which year of medical school? *
In which country are you located at the moment? *
Do you have any research experience? *

What are your research interests?

 *
If you selected "other," please describe your interests further. *
In what areas are you best able to contribute to a research project? (please select all that apply): *
Required
Do you have any research project ideas you would like to propose to the initiative? If yes, please follow this link: <insert link to research proposal form when available>
*
Please describe any timeline and working hours restrictions.  *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms