Please register your interest for the Mentorship Program below

More information on the Mentorship scheme and selection process can be found at www.aahms.org/mentorship-program.

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* Given Name

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* Surname

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* Primary email address

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* Preferred telephone number

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* Which state do you reside in?

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* Do you visit another state regularly?  If yes, which state/s?

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* What is your primary discipline?

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* What is your research focus?

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* Apart from your primary discipline and research focus, what areas of expertise can you/would you like to Mentor in?

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