2025 International Symposium - Mentor Application

International Consumer Product Health and Safety Organization (ICPHSO) 2025 International Symposium - Mentor Application
Personal Details, Education and Professional Background
Full Name*

First NameLast Name
Company/Organization
Address (Incl. Country)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email Address*
example@example.com
Phone Number

Country CodeArea CodePhone Number
Job Title
LinkedIn Profile
Are you an ICPHSO member?

YesNo
Which product safety stakeholder group do you most associate with? (Select one)

AcademiaConsumer OrganizationGovernmentLegalManufacturerRetailerService ProviderTechnical ExpertStandards OrganizationOther
Please select the topic area(s) that are most closely aligned with your expertise. (Select all that apply)

Product SafetyRisk ManagementChildren's ProductsElectrical Products/BatteriesCybersecuritySupply Chain ManagementInnovative Technologies/Artificial Intelligence/Big DataProduct LiabilityHuman FactorsRecallsSocial Media/MarketingChemical ManagementUS RegulationsInternational RegulationsSustainability and EnvironmentConsumer Product Test LabOther
Why would you like to be a mentor at the 2025 ICPHSO International Symposium?
Have you ever been a mentor before?

Yes*No
*If yes, please provide more information about your prior mentor experience(s).
In a few brief sentences, please provide three points that help describe your personality.
In one short sentence, please share your approach to consumer product safety.
Are you able to commit to the full program requirements, which includes attendance at the in-person conference on 14-15 October 2025 (including Welcome Reception on 13 October, pre-event meet up on 13 October, virtual kickoff session, a dedicated session at the symposium for all the mentors and mentees, and a post-conference follow-up)?

YesNoOther
If you selected "Other" for the previous question, please provide your additional comments regarding commitment.
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International Consumer Product Health and Safety Organization (ICPHSO) 2025 International Symposium - Mentor Application

Personal Details, Education and Professional Background