HR

Mentor Background Declaration Form

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Mentor Background Declaration Form

Confidential Document - For Internal Use Only

Personal Details:

Name

Phone

Current Location (City, Country)

Professional Background

1. Have you previously worked (or are you currently working) with any other medical education platforms similar to StudyMEDIC (Eg: coaching for MRCOG, MRCS, PLAB, USMLE, AMC, etc.)?

organization Name MRCS,

2. Are you currently associated (as employee, consultant, mentor, or any other capacity) with any platform or organization that could be considered a direct or indirect competitor to StudyMEDIC?

3. Have you signed any non-compete or confidentiality agreements with any previous organizations that might restrict your engagement with StudyMEDIC?

Conflict of Interest Declaration:

4. Do you have any financial, professional, or personal interests that could potentially conflict with your role as a mentor at StudyMEDIC?

Acknowledgment

I hereby declare that the information provided above is true and correct to the best of my knowledge. I understand that any misrepresentation or omission may result in the withdrawal of my application or termination of my engagement with StudyMEDIC.

Signature:

Date:

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Mentor Background Declaration Form

HR

Mentor Background Declaration Form

Mentor Background Declaration Form

Personal Details:

Professional Background

If Yes, please provide details:

Conflict of Interest Declaration:

Acknowledgment