Faculty of Medicine

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* 1. First Name

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* 2. Last Name

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* 3. uOttawa email adress

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* 4. Other contact email

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* 5. Study level

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* 6. Program

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* 7. Where are you located primarily?

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* 8. What lab are you in? What is your general field of study?

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* 9. What do you hope to get out of the mentorship program?

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* 10. Are you interested in transferring into a PhD?

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* 11. Would you prefer in-person or virtual meetings?

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