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  • 2020 ACHSM Mentoring Program – MENTEE APPLICATION

  • Part A: Personal details










  • Part B: Professional details

  • Part C: Your objectives from participating in the Mentoring Program



  • PART D: EXPERIENCE AND EXPERTISE SUMMARY




















  • MENTEE COMMITMENT TO THE MENTORING PROGRAM

  • Mentee Responsibilities Statement:
    1.    To be a financial member of ACHSM for the membership calendar year;
    2.    To complete the ACHSM Management Competency Assessment;
    3.    To accept responsibility for my own decisions and actions; 
    4.    To ensure absolute confidentiality of matters discussed and information supplied by the Mentor;
    5.    To discuss and seek prior approval with my Mentor if I would like to nominate them as a referee:
    6.    To work with my Mentor to identify objectives from participation in the Mentoring Program and collaboratively develop a plan designed to address these objectives;
    7.    To maintain regular contact with my Mentor (face to face meetings at least every 2 months if practicable);
    8.    To keep a record of management experience obtained during the period so that full discussion can be undertaken with my Mentor;
    9.    To initiate meetings and make regular contact with my Mentor;
    10.    To carry out tasks and projects by agreed times; 
    11.    To review performance and progress with my Mentor;
    12.    To promptly respond to requests for information from the Mentoring Coordinators and informing them of any changes in my contact details;
    13.    To participate in the evaluation of the Mentoring Program; and
    14.    To attend the Orientation session (this will be organised by your mentoring coordinator in each state).