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Mentor Sign-Up

If you are interested in being one of the mentors in PAMSA's mentorship scheme, please complete the sign-up form below to register your interest.

Name

Email

Phone number

NHS Trust

What best describes your current post?

What best describes your current post?
A
B
C
D
E
F

If other, please specify below

What specialty will your stream be focussed on?

Why do you want to be a mentor?

What are your future career aspirations?

When do you want to begin your stream?

When do you want to begin your stream?
A

Give us a quick bio with some of your achievements for our socials!

Upload a casual head shot for our marketing

Would you like to be added to a mentor-only group chat?

Would you like to be added to a mentor-only group chat?
A
B