In Conversation EOI Form

Contact Details

Given Name

Family Name

Email Address

Staff Username

Employment Details

Academic Division

Architecture, Building and PlanningArtsBusiness and EconomicsEngineering and Information TechnologyFine Arts and MusicLawMedicine, Dentistry and Health SciencesMelbourne Graduate School of EducationScienceVeterinary and Agricultural Sciences

School, Department, Unit or Centre

Which of these best describes your current position

Academic head / Assistant headAssistant deanManager

How long have you been employed at The University of Melbourne

Less than 1 yearMore than 1 year but less than 3 yearsBetween 3 years and  5 yearsMore than 5 years

Please use this space below to add any other details or contextual information about your role or responsibilities at the University.

Acknowledgement

I understand that this form is an expression of interest only, and that my eligibility for this course will be assessed based on my responses above.

• Yes

I understand that, if enrolled in this program, successful completion requires attendance for the full duration of the session.

• Yes