Mentoring programme (Form for mentorees)

CRIStAL, Inria Lille and Painlevé are setting up a peer-to-peer mentoring program. This form allows you to register to this program as a "mentoree".

Most of the fields are optional. The idea is that you provide information that you think might be helpful in processing your application and that you are comfortable with sharing with us.

This form will only be seen by the members of the Mentoring Committee. This committee will search for a mentor based on your input. Mentors fill out a similar form. That will allow us to find the best match.

Last name
First name
Email
Affiliation

Affiliation CRIStAL Inria Painlevé
Team or service
Location (building name)
Position (postdoc, associate professor,...)
Research field

For each area below, how strong would be your interest in receiving guidance from a mentor
	none	weak	moderate	strong
working environment (in particular, blending in recent hires)	working environment (in particular, blending in recent hires)none	working environment (in particular, blending in recent hires)weak	working environment (in particular, blending in recent hires)moderate	working environment (in particular, blending in recent hires)strong
institutional knowledge	institutional knowledgenone	institutional knowledgeweak	institutional knowledgemoderate	institutional knowledgestrong
collaborations, communication and visibility	collaborations, communication and visibilitynone	collaborations, communication and visibilityweak	collaborations, communication and visibilitymoderate	collaborations, communication and visibilitystrong
supervision of PhD Students	supervision of PhD Studentsnone	supervision of PhD Studentsweak	supervision of PhD Studentsmoderate	supervision of PhD Studentsstrong
HDR (habilitation)	HDR (habilitation)none	HDR (habilitation)weak	HDR (habilitation)moderate	HDR (habilitation)strong
promotion files preparation	promotion files preparationnone	promotion files preparationweak	promotion files preparationmoderate	promotion files preparationstrong
time management and organization of your work	time management and organization of your worknone	time management and organization of your workweak	time management and organization of your workmoderate	time management and organization of your workstrong
science popularization	science popularizationnone	science popularizationweak	science popularizationmoderate	science popularizationstrong
people management, being a team leader	people management, being a team leadernone	people management, being a team leaderweak	people management, being a team leadermoderate	people management, being a team leaderstrong
managing a European project	managing a European projectnone	managing a European projectweak	managing a European projectmoderate	managing a European projectstrong
improving self-confidence, leadership	improving self-confidence, leadershipnone	improving self-confidence, leadershipweak	improving self-confidence, leadershipmoderate	improving self-confidence, leadershipstrong
"back to work" (eg after a parental leave or a medical leave)	"back to work" (eg after a parental leave or a medical leave)none	"back to work" (eg after a parental leave or a medical leave)weak	"back to work" (eg after a parental leave or a medical leave)moderate	"back to work" (eg after a parental leave or a medical leave)strong
thematic conversion	thematic conversionnone	thematic conversionweak	thematic conversionmoderate	thematic conversionstrong
work-life balance	work-life balancenone	work-life balanceweak	work-life balancemoderate	work-life balancestrong
other (specify in the comment section at the end of the form)	other (specify in the comment section at the end of the form)none	other (specify in the comment section at the end of the form)weak	other (specify in the comment section at the end of the form)moderate	other (specify in the comment section at the end of the form)strong

Would you prefer a mentor from your research domain? (yes, no, no preference)
Preference for your mentor's gender (female, male, no preference)
Preference for your mentor's academic position (full-time researcher, engineer, associate professor,...)
What type of person(s) would you be comfortable or uncomfortable with as a mentor (e.g. language, experience)?
You can add any information that might be useful to the mentoring committee. You can detail what you expect from this support.
Les informations recueillies sont enregistrées dans un fichier informatisé par l'unité CRIStAL. Ces données font l'objet d'un traitement informatique destiné à l'organisation du programme de mentorat organisé conjointement par CRIStAL, Painlevé et Inria Lille Nord Europe.

Conformément à la Loi Informatique et Libertés du 6 janvier 1978 modifiée et au Réglement (UE) 2016/679 du Parlement Européen et du Conseil du 27 avril 201, toute personne peut obtenir communication et, le cas échéant, rectification ou suppression des informations la concernant. Vous avez la possibilité de contacter le délégué à la protection des données de CRIStAL (cristal-dpo@univ-lille.fr), de Painlevé (direction-painleve@univ-lille.fr) ou d'Inria Lille Nord Europe (dpo@inria.fr).