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2021 ACHSM Mentoring program– MENTOR APPLICATION
2021 ACHSM Mentoring program– MENTOR APPLICATION
ACHSM Mentoring Program – MENTOR APPLICATION
Part A: Personal details
Full name:
Title
First Name
Last Name
Postal address:
Street Address
Street Address 2
City
State
Postal Code
Afghanistan
Albania
Algeria
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Country
Phone
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ACT
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Email address:
Part B: Professional details
Current position:
Organisation:
Sector:
Location:
Part C: Your objectives from participating in the Mentoring Program
What do you wish to achieve from your participation in the Mentoring Program? (100 words max)
CV
Filename
Size
Process
Status
PART D: EXPERIENCE AND EXPERTISE SUMMARY
Can you please select what area you have experience: (you can select more than one)
Acute care
Community Health and/or Primary Care
Aged Care
Mental Health and/or Drug and Alcohol
Population Health and Planning
Aboriginal Health
Private Health Care
Public Health System
Rural and Remote Health
Others
Please select your area of interest: (you can select more than one)
General Management
Nursing Management
Medical Management
Human Resource Management and Workforce
Finance and Corporate Services
Change Management
Project Management
Strategy and strategic planning
Policy Development
Information Management and Technology
Others
MENTOR COMMITMENT TO THE MENTORING PROGRAM
Mentor Responsibilities Statement
To provide information, guidance, constructive comments and an empathic ear;
To ensure absolute confidentiality of matters discussed and information supplied by the Mentee;
To work with the Mentee to identify their objectives arising from participation in the Mentoring Program and to collaboratively develop a program to address these;
To provide a confidential and personalised source of career advice, support and guidance to the Mentee;
To provide the Mentee with advice and assistance in identifying personal development needs and how to address these;
To assist the Mentee to establish a network of support within the health system;
To assist the Mentee develop an understanding of the overall health system;
To facilitate the Mentee’s professional growth;
To meet face-to-face with the Mentee regularly (at least once every 2 months), and at short notice if possible in special situations and to maintain contact more frequently by telephone and e-mail, as agreed with the Mentee;
To undertake reviews of the Mentee’s performance and progress at the request of the Mentee during the year;
To participate in evaluation of the Mentoring Program; and
To attend the Orientation session, where practical.
I agree to participate in the ACHSM Mentoring Program and to fulfil the role of Mentor as outlined in the Responsibilities Statement.
I agree to the terms listed above