2014 Mentor Registration

[ Registration Form ]

Date of Mentor Training

Month: Year:

Note: if you have not attended a training session, you can not register yet.

Given Name

Family Name

Student Number

(no z or s )

Sex

Female
Male

CSE or UNSW Email address

Optional: If you want to be contacted at another e-mail address as well please enter it here:

Optional: Please supply a mobile or home phone number which we can contact you on:

What Degree are you enrolled in (if a double, please list your CSE Major)?

You must supply us with a "Working With Children Check" (WWCC) number. This is a free application, the form is here. Please send the finalised WWCC number (not APP number). You cannot be assigned unless we have this number.

The Program begins during O-Week on Friday 28th Feb with a Photo Scavenger Hunt and Welcome Party (2:00-8pm). Will you be available?

Yes
No

Do you Agree to abide by the UNSW Counselling Service Mentor Agreement

I Agree
Disagree

I'd like to be a mentor