First name* Suffix e.g.: van der Last name* Email address* Current position* Choose an optionPhD StudentPostdoc Current affiliation* Present at the Matching event?* Yes No Dietary whishes Are you a KNCV-member* Yes No What is the next step you plan to take in your career?* Describe who your ideal mentor would be What topics would you like to discuss with mentors? Would you prefer a mentor who is nearby (for in-person meetings), or does location not matter? Yes No No preference Do you have other wishes or expectations for this mentoring program? Deelname I agree that the information I provide in this form may be used for the preliminary study of the mentoring program.I agree to be contacted by email regarding the mentoring program and pilot program.I understand that my data will be treated confidentially and will not be shared outside the project team. I agree with the terms as mentioned above. Consent to participate*Send
