Mentors Registration Mentors Registration Full Name *0 / 40Team Leader *0 / 40Email Address *Contact Number *Location *0 / 30LinkedIn ProfileCurrent Role/Designation0 / 30Organization/CompanyCompany WebsiteTotal Years of ExperienceSelect0–5 years6–10 years11–15 years16+ yearsPlease select an optionSelectAECO (Architecture, Engineering, Construction, Operations)FintechAgritechHealthTech / Life SciencesEdtechEnergy / ClimateTechFoodTechReal Estate / PropTechDefense TechLogistics TechMedia & EntertainmentSemiconductorsGamingHospitality TechConsumer / RetailEnterprise / SaaSSocial ImpactSector-AgnosticOtherBrief Bio (for our records and introductions)What areas would you prefer to mentor in?SelectProduct StrategyMarket Entry & GTMBusiness ModellingTech & InnovationFundraisingLegal & ComplianceScaling & Team BuildingOtherPreferred Mentoring FormatSelectOne-on-oneGroup sessionsVirtual onlyOpen to both virtual & in-personAvailable Time Commitment per MonthSelect1–2 hours3–4 hours5+ hoursHave you mentored startups before?YesNoIf yes, please share your experienceWhy do you want to mentor with AmpliNxt?Are you open to participating in events like demo days, panels, or juries?SelectYesNoSelectSocial MediaWord of MouthNewsletterAmpliNxt TeamOtherSubmit
