University Hospitals Birmingham NHS Foundation Trust

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ICA Mentorship Scheme - expression of interest (mentors)

Please attach a short CV (up to four pages), and then complete the following form.

Personal details

Further details

Are you willing to take part in the evaluation of the mentorship programme? *
Are you willing to allow your biography and image to be used on the programme website and other publicity materials? *

Please note that the team will need to share some of your personal details with University of Birmingham for the purpose of registering you onto the Canvas online virtual learning environment, which will provide you with information on training and events as well as links to useful resources. If you would like to discuss this further or have any questions please email:

ICAMentorshipScheme@uhb.nhs.uk

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