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* 1. First name 

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* 2. Last name

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* 3. Institution

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* 4. Email Address

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* 5. Phone Number

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* 6. Professional Title

Please upload the following below as .pdf files: 

  • CV
  • Statement of Purpose
  • List of 3 references and contact information. 

The references should have knowledge of the applicant in his/her position as SIO.

The Statement of Purpose should include the following:

  • Description of candidate's institution
  • Description of candidate's position, role within the institution and responsibilities/scope of the candidate's position
  • The knowledge, skills, and advice the candidate desires to obtain from the mentorship (including those identified or informed by the AIEA Standards of Professional Practice)

The maximum file size for these documents is 16 mb. If you are having any problems with the form, please email aiea@duke.edu.

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* 7. CV 

PDF file types only.
Choose File

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* 8. Statement of Interest

PDF file types only.
Choose File

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* 9. References and Contact Information

PDF file types only.
Choose File

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