Privacy Collection Notice: The information on this form is being collected by the Melbourne CSHE or LH Martin Institute. The information is being collected for the legitimate interest of completing your registration in our professional development program or record your attendance to our event. Your information may also be passed on to your institution, employer or sponsor for their staff development or sponsorship program reporting purposes. If you do not provide all the information that is requested on this form it may not be possible for us to book a suitable venue, provide special requirements such as dietary and access or prepare materials prior to the commencement of your program or event. For further information please read our Privacy Collection Notice, available at https://melbourne-cshe.unimelb.edu.au/privacy.
Organisation
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Primary Position
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Position Contact Lookup
Registration Position Lookup
Registration Contact Lookup
Status
Completed
Withdrew
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Position Org Lookup
Title
Paticipant Type
Participant
Presenter
Free place
Expression of interest
Staffing
Parent Campaign
How did you hear about the program/event?
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Other
Staff News
Faculty/School communication/newsletter
Supervisor
HR contact
Colleague
Recommendation from past participant
Melb CSHE or LH Martin Institute website
Melb CSHE or LH Martin Institute email or newsletter
Melb CSHE or LH Martin Institute social media
First name
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Last name
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Preferred email address
*
Gender
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Male
Female
Rather not say
Transgender/Intersex/Other
Faculty/Division
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Faculty of Engineering and Information Technology
Chancellery
Faculty of Architecture, Building & Planning
Faculty of Arts
Faculty of Business and Economics
Faculty of Medicine, Dentistry and Health Sciences
Faculty of Science
Faculty of Fine Arts and Music
Faculty of Veterinary and Agricultural Sciences
Melbourne Graduate School of Education
Melbourne Law School
University Services
Other
Position Title
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Other
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Research
Teaching and Learning
Engagement
Leadership and management
Special requirements (e.g. venue accessibility)