INDUSTRY MENTORING NETWORK IN STEM

Transcription

1 INDUSTRY MENTORING NETWORK IN STEM MENTEE APPLICATION FORM MedTech-Pharma Program (Medical Technologies & Pharmaceuticals) 1. Program I am applying to the following IMNIS program (please select only one): MedTech-Pharma Please select your Faculty: Engineering, Computer and Mathematical Sciences (ECMS) Health and Medical Sciences Sciences 2. Applicant details University: University of Adelaide Name: ID Number: Contact Number (business hours): Mobile: School/Department: 3. Eligibility Are you in the second year of your PhD? Yes I am a second year PhD student No I am not a second year PhD student 1 P a g e

2 5. Mentee Objective: List the top 3 things you want to achieve from participating in the mentoring program Experience with industry: Please choose one of the following and provide details (max. half a page). I have worked in industry previously My research project is supported by industry I have an industry mentor/supervisor currently I have no experience with industry Other Please describe: 2 P a g e

3 7. Reasons for application: In no more than one A4 page, please provide a statement that covers the following: What motivated you to seek mentoring through this program? Why do you think you should be selected to participate in the IMNIS program? What are your career goals and how will participation in the program contribute to your career? 3 P a g e

4 8. Curriculum Vitae or track record Provide a copy of your curriculum vitae or other track record. Please attach at the end of your application. 9. Letter of support Provide a letter of support from your supervisor that discusses your suitability to participate in this program and demonstrates that they are supportive of your participation in the program. Please attach at the end of your application. 10. Commitment Please indicate you are willing to commit the necessary time to meet your mentor (1 hour per month for 12 months) and attend IMNIS events as a participant in this program. Yes I can commit No I cannot commit 11. Signature of applicant Please insert electronic signature below: Name: Date: Please note: we understand circumstances can change, but should you no longer be able to participate in the IMNIS program, you will be asked to notify the University IMNIS Liaison via within 7 days. Thanks for your interest in the IMNIS Program! 4 P a g e

5 INDUSTRY MENTORING NETWORK IN STEM (IMNIS) 2017 Program MedTech-Pharma Program (Medical Technologies & Pharmaceuticals) What is IMNIS? The Industry Mentoring Network in STEM (IMNIS) is a prestigious, award-winning initiative of the Australian Academy of Technology and Engineering (ATSE). IMNIS connects motivated PhD students with outstanding industry leaders in a one year mentoring program. Officially launched in 2015, IMNIS has successfully piloted in multiple universities in three states and was recognised in 2016 with a prestigious B/HERT Best Higher Education and Training Collaboration Award. Mentors (industry leaders) and mentees (PhD students) meet face-to-face for 1 hour each month. Guidelines are provided to both mentors and the mentees, and five state-level networking events are hosted by IMNIS to allow mentors and mentees to network and connect more broadly. IMNIS is not a job placement program. IMNIS is an opportunity to increase your understanding of industry, extend your professional skills and expand your network! There are limited places in the IMNIS and MedTech-Pharma Programs and a diverse range of the most suitable candidates will be short-listed for enrolment. This Application Form will provide your University with information for the selection process. Interested second year PhD students are strongly encouraged to apply. GUIDELINES FOR APPLICANTS Deadline for applications: COB Monday 10 July 2017 Submitting your application: Complete the application form and submit electronically to carst@adelaide.edu Attach supporting documents: 1. Curriculum Vitae or track record 2. Letter of support Notification of outcome: For more information: University contact: The University expects that applicants will be notified of the outcome on 21 July carst@adelaide.edu 5 P a g e