BOLD: Mentorship Academy Application

 
AONN+ has permission to share your email address with Mentor/Mentee to establish communication guidelines and point of contact for participation in the mentorship pilot program.
*First Name
*Last Name
* Email Address
* Phone Number
*Title
* License/Credential
* Work Location/Institution
* Company or Business Type
* AONN+ Member


* LNN Member


If Yes, which LNN?
Your role within LNN
* Experience (years)




* I am interested in being a Mentor or a Mentee


*Key Opinion Leader (KOL) Interest/Experience
A key opinion leader (KOL) is a trusted, well-respected influencer with proven experience and expertise in a particular field. In healthcare, these thought leaders could be physicians, hospital executives, health system directors, researchers, patient advocacy group members, and more. KOLs can work in partnership with AONN+ on projects to provide their insight and expertise.
* Expertise/Strengths
(Select all that apply)
Other Expertise/Strengths
* Interests/Needs - What You Hope to Gain from Mentorship
(Select all that apply)
*Please attach your curriculum vitae (CV)
Attached files must be under 2MB. Filenames cannot contain spaces or special characters.
* Upload Letter of Recommendation
Attached files must be under 2MB. Filenames cannot contain spaces or special characters.
*Would you be interested in working with AONN+ on any future projects?