Stakeholder Partnership Group Coaching Application

Contact details

Title

Name *

Surname *

University of Melbourne email address * Personal email address will not be accepted

Staff ID Number Found on your staff card

Employment details

Faculty / School *

Department / Organisational unit

Current position *

Employment status *

Continuing
Fixed term contract
Sessional / Casual

Which Cohort are you applying for? *

Cohort 2 (17 June - 15 July On Campus)

Have you completed all four Collaboration and Partnership Workshops? You will have received a certificate if you have completed all four sessions.

Declaration

I declare that all relevant questions have been answered accurately and that I have obtained the necessary support of my supervisor to undertake the Program *

The information on this form is being collected by the Melbourne CSHE. The information is being collected for the legitimate interest of completing your registration in our professional development program. The information will be used by authorised staff for the purpose for which it was collected and will be protected against unauthorised access and use. For further information please read our full Privacy Collection Notice.