MACH Mentor registration form
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Email *
Name *
Gender *
Telephone number
Position/training grade *
Specialty *
Hospital/Training region/University *
Do you have previous mentoring experience? *
If yes, please describe your previous mentoring roles/positions:
Have you had mentoring training? *
If yes, please specify course you have attended:
In which areas do you feel you can offer mentoring? *
Required
How would you like to hold meetings with a mentee? *
Required
How often would you like to meet with your mentee? *
What are your motivations for being a mentor? *
What will you bring to the mentoring role? (Knowledge or experience on research, leadership, management, career break, part-time working, career changes) *
What would you expect from a mentee? *
I confirm that I am happy for the MACH team to keep my personal information at a database. The data will be used solely for the purpose of the mentorship scheme. *
Required
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