Breadcrumb Home Faculty mentor form You must have JavaScript enabled to use this form. Current Page 1 Page 2 Complete Health and Care Research Wales Faculty Mentor profile form Please complete this form in as much detail as you can. The information you share on this form is confidential, and will be used for two purposes: To allow the Faculty team to match you with a suitable mentee. To act as an introduction to your mentee. You will also receive a copy of their matching form as the programme begins. This helps you to build a partnership by understanding the areas in which you match, and by finding things that you have in common.If you have any queries, please contact the Faculty team on research-faculty@wales.nhs.uk Our Privacy Policy is available to read on the website. Email Full name What pronouns do you use? We want to know how to correctly refer to you in the third person. ('Other' can refer to neo-pronouns or combination pronouns). He, him She, her They, them Prefer not to say Prefer to self-describe (plese use free text chose other) Other… Enter other… Position / Job role Organisation Location Please state where you are in the UK, as this may impact face to face mentoring Professional web page, online profile or social media Research interests Please provide a brief summary of your career highlights to date What do you enjoy most about your role? Are there any career-related challenges or concerns you have faced that you would feel comfortable sharing for the purpose of mentoring a mentee through a similar situation? Please outline these if you feel comfortable doing so. What are your hobbies and interests? Please let us know any other information about yourself or your expectations of the mentoring programme that you feel will be useful when matching you with a suitable mentee. What particular skills and experience do you have that you could offer a mentee? For example mentoring skills, personal attributes or career experiences Please indicate how many mentees you would be willing to mentor during cohort 1: 1 2 3 Leave this field blank