Melbourne Academy Expression of Interest form

Required fields are marked with an asterisk (*).

Contact details

Given name *

Family name *

Email address *

Staff username This will allow us to add you to the Canvas community page if accepted.

Staff ID Number Found on your staff ID card and usually contains 6 digits

Employment details

Faculty

Architecture, Building and PlanningArtsBusiness and EconomicsEducationEngineering and Information TechnologyFine Arts and MusicLawMedicine, Dentistry and Health SciencesScienceOther

School, Department, Organisational Unit E.g. Melbourne Dental School, Department of Accounting

In what year did you complete your PhD? *

Which of the following best describes your current position? *

-- Please Select --Education and researchResearch focussedEducation focussedAcademic specialist

Contract type *

-- Please Select --Full-time fixed-termPart-time fixed-termCasualContinuing

How long have you been employed at The University of Melbourne? *

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

Please use the 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 80% attendance and satisfactory completion of all assignments. *

• Yes