HBIC Award Potential Mentors

  • Please complete this form to signal your interest in serving as a mentor for the HBIC 2023 Award Competition.

    View the HBIC Mentor FAQs

    Visit the HBIC Award overview page

  • Name * Required
    Please enter your name
  • Please enter the name of the institution from which you are offering to base your mentorship.
  • Please provide a link to your online profile
  • Please provide a link to the website of the institution or lab from which you are offering to base your mentorship.
  • Please provide keywords that describe your research interests, specifically those you would like to pursue through a mentorship project.
  • Email * Required
    Please enter the email address you would like the HBIC team to use to communicate with you.
  • If different than the email provided above, please enter the email address you would like potential HBIC award applicants to use to contact you to propose a mentorship project.
  • Please indicate with which HBIC Award sponsor society you are affiliated.
  • Availability for the 2023 Award Competition * Required
    Please indicate whether you are available to take on a mentor as part of the 2023 HBIC Award competition.
  • Inclusion on the list of potential mentors * Required
    Please confirm that you wish your name, institution, and email to be listed on the HBIC Award webpage as a potential mentor.