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Mentoring Matching Feedback Survey
Thank you for your participation in the programme! You should fill out this form only if you want to continue being paired with your current mentor.
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1.
Full Name
(Required.)
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2.
Email address
(Required.)
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3.
Affiliation
(Required.)
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4.
Country of Affiliation
(Required.)
5.
Country of origin or nationality
6.
Gender you identify with
Male
Female
Non-binary
Prefer not to answer
Other
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7.
Do you represent industry or academia at the moment?
(Required.)
I represent academia
I represent industry
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8.
If you are representing academia, how many years has it been since your PhD was awarded? If you represent industry, please select "I am in industry".
(Required.)
I am in industry
I am an undergraduate student
I am a masters student
I am a PhD student
I am a research assistant
< 3 years
3-5 years
5-10 years
10-15 years
>= 15 years
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9.
If you are representing industry, how many years of experience do you have in industry? If you represent academia, please select "I am in academia".
(Required.)
I am in academia
< 3 years
3-5 years
5-10 years
10-15 years
>= 15 years
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10.
Mentor's Full Name
(Required.)
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11.
Mentor's Email
(Required.)
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12.
Mentor’s Affiliation
(Required.)
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13.
Mentor’s Country of Affiliation
(Required.)
14.
Mentor’s Country of origin or nationality
15.
Do you have any general feedback?