Medic Mentor Registration Form

• Member type*
  • Applying Student
  • Parent
  • Teacher
  • University Student
  • Healthcare Professional
• Name*
  First Last
• Email*
• Phone*
• Password*
  Enter Password Confirm Password
  Strength indicator
• Which venue is the easiest for you to visit? (for workshops, conferences and teaching events)
  • London
  • Exeter
  • Birmingham
  • Lancaster
  • Nottingham
  • Scotland
  • Wales
  You will be able to see notices of upcoming events local to you in your membership area.
• Which specialty interests you/ are you studying?
  • Medicine
  • Dentistry
  • Veterinary Medicine
  This will enable Medic Mentor to keep you up to date with useful competitions, publication opportunities, volunteering and event notices that are most relevant to you.
• Your Child’s name
• Year of study
  • 7-9
  • 10
  • 11
  • 12
  • 13
  • S3
  • S4
  • S5
  • S6
  • Gap Year
  • Undergraduate
• Childs Year of study
  • 7-9
  • 10
  • 11
  • 12
  • 13
  • S3
  • S4
  • S5
  • S6
  • Gap Year
  • Undergraduate
• Personal Address
  Disclaimer: your personal address will be kept confidential
• Your home Address
• School
• Job Title
• School Address
• School Telephone
• Roughly how many students at your school are interested in a medical career?
• Do you have students from disadvantaged backgrounds requiring free places?
• Would you like to receive the Newsletter, Seminar Study Series and updates on Cv boosting opportunities, competitions and events?*
  • Yes
  • No
• Would you like to have regular contact with a Mentor and receive mentoring?*
  • Yes
  • No
• What is your year of study?
• Tell us about your application journey and teaching experience (this will feature in your profile description)
• Stage of training
• Which field do you specialise in?
• Where do you work?
• Tell us about your teaching experience
• Select A University that you currently/used to attend
  University of AberdeenBarts and the London School of MedicineUniversity of BirminghamBrighton and Sussex Medical SchoolUniversity of BristolBuckingham medical schoolUniversity of CambridgeCardiff UniversityUniversity of DundeeDurham medical schoolThe University of EdinburghExeter UniversityUniversity of GlasgowHull York Medical SchoolImperial College School of MedicineKeele UniversityKing’s College London School of MedicineUniversity of LancasterUniversity of LeedsUniversity of LeicesterUniversity of LiverpoolLondon School of Hygiene and Tropical MedicineUniversity of ManchesterNewcastle University Medical SchoolUniversity of East AngliaThe University of NottinghamUniversity of OxfordPlymouth University Peninsula Schools of Medicine and DentistryQueen’s University BelfastThe University of SheffieldUniversity of SouthamptonUniversity of St AndrewsSt George’s, University of LondonSwansea UniversityUniversity College LondonThe University of WarwickThe Royal Vet College
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