FasterCures LeadersLink Mentor and Expert Questionnaire (2024-2025)

Application Instructions

8% of survey complete.

Thank you for your interest in becoming a mentor or expert for the FasterCures LeadersLink Program!

The questionnaire consists of a series of multiple choice and brief narrative response questions and is estimated to take approximately 10-15 minutes to complete. Applicants are encouraged to write and save their responses in a word processing program and copy and paste responses into the application form when submitting the application. To preview the application questionnaire, please download the PDF version. Participants are able to start an application and come back to it later but in order for this setting to work properly, the respondent must use the same device and web browser they used to start the survey.

If you have any questions about completing the questionnaire or experience technical challenges, please contact Katie Forth at fcleaderslink@milkeninstitute.org or 202-336-6414. For additional details on the FasterCures LeadersLink Program, please visit our program webpage.

Question Title

* 1. Please enter your contact information.

Name:

Title:

Organization:

Address Line 1 (Street, Apt/Suite, etc.)

Address Line 2 (City, State, Country, Postal Code)

Email:

Phone:

Website:

Question Title

* 2. Are you interested in serving as a mentor or as an expert on issues related to engaging diverse patients across the spectrum of R&D?

Program mentors are assigned to an individual mentee and provide one-on-one, consistent support throughout the program. Experts are not directly paired with a single mentee, but rather commit up to 10 hours of time per year for guidance, feedback, or support related to mentees' goals and capstone projects as requested. More information on the responsibilities of mentors and experts can be found in this pdf.

Mentor

Expert Pool

Both