Internship 2013 – Mentor Feedback Form

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Mentor Details

Greeting *

First Name *

Last Name *

Designation *

Institution [ Affiliation ] *

Preferred email address *

Brochure and Website Specific Information Requested

1. Your Passport Size Photo for brochure and website
This is how last year's mentor's photos were shown in the brochure

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Maximum upload size: 516MB

2. Upload your bio-data (your profile), in case you do not have time to type it in

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Maximum upload size: 516MB

3. Your Brief Bio that can be used in the brochure and website

4. Your comments about mentorship experience and about this program

5. Your permission to include your information and comments in the brochure and website *