Neuroscience Mentor Database

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This form is open to individuals (18 years and older) who are interested in answering questions from younger students about their career, open to being a remote mentor, supporting students on proposed project collaborations, etc. We invite undergraduates, graduate students, post-doctoral researchers, recent graduates, and early-career professionals to sign up for this open database!

This database is created and maintained by Simply Neuroscience volunteers. It is independent from the Action Potential Advising Program (APAP), which pairs student advisees with professional advisors through long-term mentorship matches.

No need to be a part of APAP to submit or access this Neuroscience Mentor Database. To clarify, we will not be matching individuals with mentors/mentees based on submissions to this Google Form -- that's only through APAP!

Any questions? Email us at advisingprogram@simplyneuroscience.org

What is your email address? *

For our internal records in case we need to contact you!

Please note that your responses to the following questions will be made available through the public database hosted on Simply Neuroscience's website. Some questions are marked as required while others are optional.

What is your full name? *

(optional) What are your pronouns?

Example: she/her, he/they, they/them

(optional) Do you identify as:

African / African descent

Asian / Asian descent

Black

Disabled

First generation higher education student

Gender minority

Hispanic/Latinx

Immigrant

Indigenous

LGBTQIA+

Low income student

Neurodivergent

Person of color

White

Other:

What is your current role, position title, career stage, etc.? *

Example: PhD candidate in Neurobiology, Life Sciences Research Associate

What institution, company, or organization are you currently affiliated with?

Example: Ashoka University, Pfizer

What are your areas of academic, clinical, and/or professional expertise? *

Example: neuroethics, behavioral neuroscience, psychiatry, Alzheimer's Disease, stroke

Other than English, what languages do you speak, read, or write? *

Please write N/A if you are only an English-speaker.

(optional) What is the URL of your LinkedIn profile?

Example: Our LinkedIn page is https://www.linkedin.com/company/simply-neuroscience/

(optional) What is your Twitter username without the URL?

Example: Our Twitter username is @simplyneurosci

(optional) What is your Instagram username without the URL?

Example: Our Instagram username is @simplyneuroscience

(optional) What is the URL of your personal website or academic webpage?

Example: Our website is https://simplyneuroscience.org/

(optional) Can we share your email address on the public database? Please select one of the options below or "Other" *

Yes, I am comfortable with my email address being listed on the database.

No, I would prefer not to list my email address on the database.

No, I would prefer to not have my email address on the database. However, if students reach out to Simply Neuroscience and request my contact information, I am okay with Simply Neuroscience sharing my email address with the student individually.

Other:

What is your preferred method of communication?

Interested in receiving news about upcoming events, opportunities, and resources?

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Any suggestions, feedback, concerns?

If you have any urgent questions, please email advisingprogram@simplyneuroscience.org to receive a faster response

If any of your information changes, please (1) re-submit and (2) leave a quick note above about re-submission so we can delete the earlier response.

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