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Health and Care Research Wales Faculty Mentor profile form

Your personal data will always be treated in confidence and when anonymised with data from other applicants will help us monitor the diversity of the field of applicants, and the success rate by protected characteristic. The summary data may be published by Health and Care Research Wales in a report. We will always ensure that it is not possible to identify individuals from the summary data.

Your responses to questions regarding your gender, if you are disabled, your ethnic group, sexual orientation, your religion or belief, your age and caring responsibilities will never be made available to the those considering your application.

All the data we collect is treated in accordance with the Data Protection Act 2018 and UK General Data Protection Regulation (GDPR).

Our Privacy Policy is available to read on the website.

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)

Arall...

Position / Job role

Organisation

Location

Please state where you are in the UK, as this may impact face to face mentoring

Research interests

Please provide a brief summary of your career highlights to date

What do you enjoy most about your role?

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: