Become a Mentor

First Name *:
Last Name *:
Email Address *:
Primary City *:
Primary City - Other:
Occupation *:
Organization *:
How did you hear about Neuro Nexus?:
How are you looking to be a part of the NeuroNexus community & competition? (Select All That Apply) *:
What are your areas of expertise? (Select All That Apply) *:
How much time do you estimate you would have available for the teams/competition over the 6-week period? *:
Please tell us a bit more about your experience and where you think you can help innovators the most *:
Are you interested in providing continuity mentorship to teams which have graduated from the NeuroNexus programs, or as part of our Microgrant Initiative?:
Check the following box to be invited to a post-competition virtual networking event for the mentor and champion network of the NeuroNexus community: