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* 1. Name:

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* 2. Email:

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* 3. Phone

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* 4. Have you previously studied at the University of Melbourne?

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* 5. Year graduated:

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* 6. What degree(s) did you study?

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* 7. Years of professional work experience:

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* 8. Career area:

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

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

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

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* 12. 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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