Please note that responses to these questions will only be used for the purpose intended and will not be shared.

Personal Info

First Name *

Middle Name

Last Name *

Email *

WWN Member ID *

Phone *

Time Zone * []

Mailing Address *

City * []

Zip / Postal Code * []

State / Province * []

State - If Other * []

Country * []

Demographics

Gender:

If other:

Country of origin *

Present Institution *

Race

If other:

Ethnicity

Language (other than English):

Platforms

URL

Research gate

Google scholar

Facebook

Twitter

Emergency Contact Info

Name

Phone

Relationship

Matching Criteria

If other:

Age Group

Current Level of Training *

If other:

Stage in Career *

If other:

Short Bio (200 words max) *

Password _{must be between
8 and 20 characters}

Password Confirm

Mentoring agreement

Mentorship Program
Code of Conduct

Peers will not practice, condone, facilitate or collaborate in any form of discrimination on the basis of ethnicity, race, sex, sexual orientation, age, religion, national origin, marital status, political belief, mental or physical disability, or any other preference or personal characteristic, condition or state.
Peers will respect the privacy and confidentiality of their Mentors and others utilizing peer support services.
Peers will never engage in sexual/intimate activities with their Mentors and others utilizing peer support services.
Peers will avoid conflicts of interest that compromise the relationship between themselves and theirMentors.
Peers will never intimidate, threaten, harass, use undue influence, physical force or verbal abuse, or make unwarranted promises of benefits to their Mentors and others utilizing peer support services.
Peers will not accept gifts of significant value from their Mentors and others utilizing peer support services.
Peers will maintain high standards of personal conduct that includes keeping commitments to and giving of dignity and respect to all people.

I agree to the Mentoring Agreement

I agree to the Privacy Policy

I agree to the Code of Conduct

Mentee Profile

Personal Info

Demographics

Platforms

Emergency Contact Info

Matching Criteria

Mentoring agreement

Mentorship ProgramCode of Conduct

Mentorship Program
Code of Conduct