Page 1: Careers Champions Registration Form

5.5. Have you any Out of Programme (OOP) time? Required
6.6. Have you/do you work less than full time (LTFT)? Required
7.7. Have you ever taken a career break? Required
8.8. Have you ever worked abroad (in medicine)? Required

Thank you for your interest in joining the Careers Champions scheme.

Your contact details will be made available to all Midlands & East Trainees, Educators and staff via the website.

Please note that by completing this form to join the scheme, you agree to your details being used in this way.