MENTEE APPLICATION FORM
|MENTEE APPLICATION FORM |
|If you are interested in participating in the mentoring programme, please complete the on-line application form and send it to amp@ by 5 February |
|2021. |
| |
|Providing the following is for the sole purpose of matching each Mentee with a suitable Mentor. |
|PERSONAL: | |
|First and Last Name: | |
|CONTACT DETAILS: | |
|Position: | |
|Institution: | |
|Country: | |
|Email: | |
| | |
|CONCISE DESCRIPTION OF YOUR ROLE AT YOUR | |
|INSTITUTION: | |
|(max 100 words) | |
| | |
|ACTIVITIES AND | |
|INTERESTS: | |
| | |
|CAREER CHOICE | |
|State if there is anything you would | |
|particularly like to achieve in your | |
|professional/personal life that you feel a | |
|Mentor could support you with. | |
| | |
|WHAT HELP WOULD YOU LIKE TO RECEIVE FROM A | |
|MENTOR? | |
|Mention if you have any strong preferences | |
|about what you are looking for from a | |
|Mentor: | |
| | |
| | |
|REASONS FOR APPLYING TO THE ABSTRACT MENTOR | |
|PROGRAMME | |
| | |
|ABSTRACT TITLE | |
|DRAFT ABSTRACT | |
|(400 words maximum) | |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
|TECHNICAL SESSION FOR ABSTRACT SUBMISSION | |
|(please indicate code and title/ | |
|Ex: A1.1 Behaviour, Performance and | |
|Psychosocial Issues in Space) | |
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