Peer Mentoring Program - Application

REGISTER TO BECOME A STUDENT MENTOR

Fields marked * are required for submission

Your Information
Please enter your first name
Please enter your last name
Your student number is requiredInvalid format
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Your Contact Information
Your Deakin email address is requiredInvalid Deakin email
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Your Study Information
Please enter the course you're enrolled in
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Please enter your intended major
Optional (For Mentor group matching purposes)
Please respond to the following questions:
 A value is required.Min number of chars not met (100)
 A value is required.Min number of chars not met (100)
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 A value is required.Min number of chars not met (50)
 A value is required.Min number of chars not met (10)
Please provide a personal or academic reference to support your application

Please tick one of the following:

All successful applicants will be contacted with their confirmed interview time and location.

Declaration: I agree to the following Declaration:

I am able to commit to a one day training session and other important dates as required by program. I understand that to be eligible for the award of a Deakin University Student Mentor Certificate and $100 Deakin Card top up, I must meet all program responsibilities by attending training, undertaking a minimum 20 hours of mentoring (inclusive of training), and be committed to providing regular evaluation to Program Staff throughout the duration of program. I consent for my email address and mobile number to be distributed for the purpose of mentee allocation of new students so that exchange of communication occurs as required.

You need to agree to the above Declaration in order to proceed

The information collected on this form will be used for the purposes of administering the Undergraduate Peer Mentor Program. The University manages personal information, including requests by individuals for access to their personal information, in accordance with the Information Privacy Act 2000 (Vic). The University's information privacy policy may be viewed at http://theguide.deakin.edu.au/ or by contacting the University's Privacy Officer on (03) 9246 8114 or at privacy@deakin.edu.au.


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