RHD Study Space Question Title * 1. First name Question Title * 2. Last name Question Title * 3. Student number Question Title * 4. University email address Question Title * 5. Course Question Title * 6. Principal supervisor Question Title * 7. Are you enrolled full time or part time? (NB: Part time students may be allocated a time-share space) Full time Part time Question Title * 8. What was your commencement date? (dd/mm/yyyy) Question Title * 9. Do you have any leave planned in the next 12 months? Yes, leave of absence Yes, study away No If yes, for how long? Question Title * 10. Will you be submitting in the next 6 months? Yes No Question Title * 11. Have you submitted your intention to submit form or 80 word summary to MSGR? Yes No Question Title * 12. Have you had a study space in the Sidney Myer Asia Building before? Yes No If yes, for how long? Question Title * 13. How many hours per week would you use the study space? (please try to be as accurate as possible to avoid underused study space) Question Title * 14. If you are allocated a space on a time-share basis, what are your preferred days? Monday am Monday pm Tuesday am Tuesday pm Wednesday am Wednesday pm Thursday am Thursday pm Friday am Friday pm Saturday Sunday Question Title * 15. Will you be using your own device e.g. laptop? Yes No Question Title * 16. Do you have any particular difficulties working at home? No Yes If yes, please provide more information Question Title * 17. Do you have any other special needs (e.g., child care, medical issues, disability, etc.)? No Yes If yes, please provide further information Done