ACCELERATE: Mentoring for Medical Innovation 2025 - Application Form
To submit an application please complete this form by Friday 10/01/2025. Your responses will be captured over three areas: 1. Information about you and why you want to apply; 2. Outline of commitment for participants to agree and adhere to and; 3. Any additional comments/feedback (optional). Click the 'Submit' box at the end to submit your application.
Your information
The information collected in this application form will be used for the purpose of shortlisting applicants for the scheme. This information will not be shared outside of the scheme management team without your permission, if you would like to access your responses, withdraw your application and/or have your data erased, please contact the ACCELERATE Programme Manager, Nasema Uddin on nasema.uddin@ucl.ac.uk
About you
Name
*
First Name
Last Name
UCL / NHS Email
*
example@example.com
Confirm UCL / NHS Email
*
example@example.com
What is your career stage?
*
Leading Researcher (PI or equivalent), 5+ years experience
Leading Researcher (PI or equivalent), under 5 years experience
Recognised Researcher
Postdoctoral Fellow
Other
If other, please specify
What is your research background? [maximum 100 words)
*
What is your area/s of expertise? [maximum 100 words]
*
Provide a brief overview of your work as it relates to healthcare research [maximum 100 words]
*
Please indicate if you are connected to any of the UCL Therapeutic Innovation Networks (TINs) listed below:
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Biologics
Cell and Gene Therapies
Devices and Diagnostics
Regenerative Medicine
Repurposing
Small Molecules
None
Comments - please elaborate on your involvement, if applicable.
Which translational research areas listed below, do you wish to be mentored on? Please tick a maximum of three areas only (you will then be matched with a mentor on one of your chosen areas):
Biologics
Cell & Genes
Devices & Diagnostics
Regenerative Medicine
Drug Repurposing
Small Molecules
Artificial Intelligence (AI) / Data & Insights
Digital / Science Communications
Entrepreneurship
Industry / Partnership Development
Commercialisation
Patient, Public Involvement & Engagement (PPIE)
Intellectual Property (IP)
Commitment for Participants
Successful participants must ensure they are available for the full duration of the online training workshop. As a guide, the workshop will last for approximately 2 hours with some light reading expected before the workshop (Pre-workshop resources will be provided nearer the time).
Successful participants will be expected to:
1. Participants are required to sign-up in the knowledge they need to have their cameras and microphones switched on for the online training and will be working in breakout rooms. 2. Be open to new ideas and ways of working. 3. Be an engaged and active team member for group working.
Please check the boxes below to confirm that you have read and agree to the above commitment for participants
*
I confirm that I have read and agree to section 'Commitment for Participants' above, should my application be successful for ACCELERATE Innovation: Mentoring.
Other (please specify below)
Please specify
Please use this space for any additional comments
Submit
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