2013 Mentor Registration

[ Registration Form ]

Date of Mentor Training

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

Given Name

Family Name

Student Number

Sex

Female
Male

CSE login

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)?

Which of these categories would you be suitable to help with?
(tick all that apply)

Are you comfortable with having a Mentee of the opposite sex?

Yes
No

What other languages do you speak?

Other Cantonese Hindi Indonesian Japanese Korean Malaysian Mandarin Thai Vietnamese
If other:

If you are going to be in a UNSW Residential College in 2013, which one will you be in ?

Are you willing to undergo a Police Check for a "Working with Children" certificate?

Yes, I'll take one.
No

Yes
No

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

I Agree
Disagree