APPLICATION FORM AND MENTORSHIP AGREEMENT FOR  INTERNATIONAL ONLINE MENTORING SERVICE .

Fellow Biomedical Scientists,

The first step in the mentoring process is for you to obtain the mentoring hand book.

This will be followed by your enrolment into the international online mentoring course on your own research topic or our own research topic .

Additional  mentoring service will be carried out as you respond to our programmes as advertised in www.forums.authoraid.info, www.researchgate.net or https://www.philipnelsoninstituteofmedicalresearch.wordpress.com, according to your research needs.

Further mentoring service will be carried out as we work on your project up to any level.

Please find attached, an application form for registration of mentors and mentees and mentoring agreement form for mentoring service.

Thank you and welcome to our mentoring services.

PNIMR works beyond your expectations.

PNIMR researchers are set to accomplish your dreams and aspirations.

CONTACT PNIMR TODAY.

The Mentoring  Administrator,

Philip  Nelson Institute of Medical Research (PNIMR).

11, John Fayemi Close, Akesan Bus stop, LASU- Igando road,

Alimosho Local Government Area, Lagos State, Nigeria.

P . O Box 55601, Falomo, Ikoyi, Lagos 101008, Nigeria, West Africa.

Telephone: +2348173175179, +2348140624643, +2348173175179.

E-mail: philipnelsoninstitute@yahoo.com.

https://www.philipnelsoninstituteofmedicalresearch.wordpress.com

 

PNIMR

PHILIP NELSON INSTITUTE   OF MEDICAL RESEARCH

 

APPLICATION FORM FOR REGISTRATION AND MENTORING AGREEMENT FORM.

 

  1. NAME OF MENTOR:…………………………………………

CONTACT DETAILS: ……………………………………………………

ADDRESS OF MENTOR:……………………………..........................

TELEPHONE:…………………………………………………………….

EMAIL:……………………………………………………………………

WEBSITE:…………………………………………………………………

GENDER:…………………………………………………………………

RESEARCH INTERESTS:…………………………………………………

SKILLS:…………………………………………………………………..

ACADEMIC ACHIEVEMENTS:…………………………………………

2. NAME OF MENTEE:…………………………………………………

ADDRESS OF MENTEE:…………………………………………………

TELEPHONE:…………………………………………………………….

EMAIL:……………………………………………………………………

WEBSITE:………………………………………………………………..

GENDER:……………………………………………………………….

RESEARCH INTERESTS:………………………………………………..

SKILLS:………………………………………………………………….

MENTEE GOALS:………………………………………………………

ACADEMIC ACHIEVEMENTS:………………………………………….

SUPPORT NEEDED FROM MENTOR:………………………………...

TARGET DATE:…………………………………………………………..

AMOUNT PAID:………………………………………………………..

  1. DECLARATION:  We are voluntarily entering into a mentoring relationship that we expect to benefit all participants as well as our organization.

 We expect this to be a rewarding experience , with most of our time spent on substantive development activities.

To ensure a positive relationship, we agree to the following :

 

We define confidentiality as follows:……………………………………………………………………………………………………………………………………………………………………………………………………………

Duration of relationship:………………………………………….

Frequency and length of meetings:………………………………

We will review our progress after…………………….months.

We have defined the context of this relationship as:…………………………………………………………………..(career development, skills development, orientation to organization or position etc.).

We have agreed to focus on the goals and actions outlined below:…………………………………………………………….

……………………………………………………………………………………………………………………………………………..

We agree to a no- fault conclusion of this relationship , if for any reason , it seems appropriate.

SIGNED AND DATED BY PARTNERS IN THIS AGREEMENT.

NAME OF MENTEE:……………………………………………

SIGNATURE:…………………………………………………….

DATE:………………………………………………………………

NAME OF MENTOR:……………………………………………

SIGNATURE:…………………………………………………….

DATE:………………………………………………………………

PLEASE RETURN THIS APPLICATION FORM WITH US$ 40 = ONLY  AFTER COMPLETION TO RECEIVE A MENTORING HANDBOOK .

PLEASE RETURN THIS FORM TO: philipnelsoninstitute@yahoo.com