Mentorship Application Name * First Name Last Name Email Address * Pronouns * ... she/her/hers he/him/his they/them no pronoun/use my name ask me Mobile Number * Do you identify as an Aboriginal and/or Torres Strait Islander person? * ... Yes No Postcode * State/Territory * ... QLD NSW VIC ACT TAS SA WA NT Employer / School * Total length of service? * Are you a: * Undergraduate Nurse / Midwife Assistant Nurse Enrolled Nurse Registered Nurse / Midwife Other Other Are you currently employed: * Full-time Part-time Casual Temporary Contract 457 Visa Not working currently Why are you interested in getting a mentor? Are there any particular things you'd like a mentor to help you with? * What special interests, hobbies, or leisure activities do you enjoy when you're not studying or at work? * Please share any additional information about yourself? How did you hear about our mentorship program? * Thank you! I will be in touch very soon. I can’t wait to start working with you.-the Surgi Nurse Connect with us on social media!
