CRS BeNeLux & France Local Chapter Survey for members interested in the Mentorship Program in the role of mentors
1. Please enter your name: *
2. Where are you originally from? Please specify: *
3. What is your current position? *
4. Please enter your field of research: *
5. How many years of professional experience do you have (years spent in academia or industry upon completion of your PhD)? *
6. In which countries have you worked during your career? *
7. In which country are you currently located? *
8. During your career, have you covered one or more of these roles? *
9. What are you able to provide advice on? *
10. We appreciate your time and, therefore, would like to know how often do you wish to connect to your mentee?
Clear selection
11. Even though the interaction with your mentee might be lifelong, how long do you wish to be connected to your mentee in the context of this program?
Clear selection
12. In which format would you prefer the mentorship program to be set?
Clear selection
13. What would be the best way of communication with your mentee? *
14. Are you available to have more than one mentee? *
15. If you are available to have more than one mentee, please specify a maximal number of mentees that you are willing to mentor:
16. Would you like your mentee(s) to be: *
17. Are there people you don’t want to be selected as your mentees? *
18. If there are people you don't want to be selected as your mentees, please provide the names or the group of research:
19. If you have any other comment or suggestions for this mentorship program please write them below:
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