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* 1. Name:

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* 2. Student email:

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* 3. Alternate email:

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* 4. Student number:

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* 5. Phone

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* 6. Current level of study:

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* 7. Faculty:

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* 8. Course and expected year of completion:

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* 9. Career goal:

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* 10. Describe your current and/or previous involvement in sport:

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* 11. Please list your significant sporting achievements over the past 24 months:

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* 12. Please list any current or past representative teams/squads:

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* 13. Describe your hobbies/interests (this will be used to help match you to your mentor):

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* 14. Please provide a brief statement outlining how joining the Strong Women Network will assist you in your sporting, academic or career endeavours (max 250 words):

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* 15. In what ways will you be able to interact with your mentoring partner?

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* 16. STRONG WOMEN NETWORK MENTORING PRIVACY STATEMENT.

The information on this form will be used by the coordinator of the appropriate career mentoring program at the University of Melbourne to match students and mentors. Contact details will be retained in confidential files to enable the coordinator to communicate with participants. Only matched mentoring pairs will be given each other's contact details. Information may also be passed on to other groups within Melbourne University Sport for the purpose of updating databases and producing communications relevant to Melbourne University Sport. The University has a detailed Privacy Policy and you can contact the Privacy Officer with any questions about how the University deals with personal information. 

I understand and accept the Strong Women Network Mentoring Privacy Statement:

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