MENTOR APPLICATION FORM

Thank you for your interest in becoming a mentor with the Women for One Health (WfOH) Network.

Please complete this form to help us understand your background, expertise and mentorship goals.

SECTION 1: PERSONAL INFORMATION

Full Name: *

Email Address: *

Phone Number (Optional)

Current Organization/Affiliation: *

Position/Title *

Country/Location: *

SECTION 2 : PROFESSIONAL BACKGROUND

Education: *

Field(s) of Expertise?: *

Briefly describe your experience in relation to One Health and mentorship (max 100 words): *

SECTION 3 : MENTORSHIP INTEREST

What are your goals as a mentor within the WfOH network? (max 250 words) *

What areas are you keen to mentor on? *

Preferred Mentee Level: *

How many mentees are you willing to mentor at a time? *

Preferred Mode of Communication with the mentee (Check all that apply): *

SECTION 4 : ADDITIONAL INFORMATION

Have you previously formally mentored individuals? *

Yes

Is there any additional information you would like to share regarding mentorship approach or your commitment level? Would you be available weekly or monthly? (Optional)

Declaration

I confirm that the information provided in this application is accurate to the best of my knowledge. I understand that becoming a mentor with WfOH is a voluntary commitment aimed at fostering professional growth and inclusivity in the One Health field.