Page 1 of 2
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
Foundation Year 1
B
Foundation Year 2
C
Core Surgical Training
D
Internal Medical Training
E
Specialty Training
F
Other
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
As soon as I can!
Give us a quick bio with some of your achievements for our socials!
*
Upload a casual head shot for our marketing
*
Click to choose a file or drag here
Size limit: 10 MB
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
Yes
B
No
Submit
