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The e-mentorship program by the Society of NeuroInterventional Surgery (SNIS) is dedicated to advancing the field of neuroendovascular medicine through a structured and interactive learning experience. This program aims to foster the exchange of specialized knowledge and expertise between seasoned professionals and emerging practitioners.

The mentor will provide mentorship to one mentee for a duration of one year. During this year, the mentor is expected to showcase procedures to facilitate teaching based in real situations. You must be a senior member of SNIS in order to apply to serve as an e-mentor. Please refer to e-mentorship website for more details about the program and its requirements.

SNIS is pleased to offer each mentor an honorarium of $1,000 per month, in consideration of your time and expertise, for the total of the 12 months of the mentorship program.
Personal Information:

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* 1. Name

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* 2. Country of residence and practice

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* 3. Default time zone

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* 4. Language(s) spoken (Please list languages spoken proficiently)

Contact Information:

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* 5. Primary Email

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* 6. Secondary Email

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* 7. Primary phone contact

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* 8. Office phone contact

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* 9. Correspondence address

Professional Background:

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* 10. Background Training

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* 11. Current Position

Neuroendovascular Experience:

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* 12. Years in Practice in Neuroendovascular Surgery (choose one):

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* 13. If you have specific areas of clinical or academic focus, please list them here:

Technical Setup:
Required Documents

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* 14. Please upload an updated CV:

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