In2research Mentor / Placement Host Expression of Interest Form 2022-23

1. First Name *This question is required.

2. Last Name *This question is required.

3. Email address *This question is required. This question requires a valid email address.

4. What is your mobile number? *This question is required.

5. What is your job title? *This question is required.

7. Where are you based? (Town/City) *This question is required.

8. What is your University, Company or Organisation? *This question is required.

9. What Department are you based in? *This question is required.

11. Who are/were you funded by? *This question is required.

12. What are your honours?

Please identify 3 key words that best describe the specific field of work/research you have expertise in.

15. Keyword 1 *This question is required.

16. Keyword 2 *This question is required.

17. Keyword 3 *This question is required.

18. Please identify at least 4 key words that best describe the specific field of work/research you have expertise in. *This question is required.

19. Please write a short bio about you and your research that you would be happy to have shared with In2research participants if you are selected to be part of our programme. Make sure to mention details of your current work. *This question is required.

20. Why do you want to mentor and/or be a placement host for the In2research programme? And what do you hope to gain from mentoring and/or being a placement host? Please summarise your thoughts in no more than 250 words. *This question is required.

In2research Mentor / Placement Host Expression of Interest Form 2022-23

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