Global Utilities

La Trobe University
In2science Peer Mentoring in Schools Program

Register to become an In2science Peer Mentor

Eligible University students wishing to become peer mentors must complete and submit the following form. Once submitted a member of the In2science Team will contact you shortly.

 

Personal Details

First Name:
  please put a preferred name in brackets at the end if different: eg Joshua (Josh)
Family Name:
 
Gender
 
Other languages spoken
  If you are fluent in any language(s) other
 than English, please indicate language(s)
Semester address: (number and street)

  
Suburb/town:
  
Post Code:
  
Phone:
  
Mobile: (no spaces)
 

University Email:

   Please use your university allocated email ONLY - and check your spelling carefully

Transport:
Do you have a current Working With Children check:
If "Yes" enter Card No.:
What is a Working With Children Check??

 

University Details

University:
Campus:
  
Student category:
Year level in 2012:
  
Degree program:
  
Major(s):
 

 

In2science Program - Required Information

I am willing to mentor in the following subjects
 Hold the Ctrl key and left-click to select multiple subjects
 
(remember that schools tend to teach General Science up to Year 10 - usually on a topic rotation)
Preferred Year Level to mentor:
What school did you attend for VCE?:

 School name
 
Would you consider mentoring at your old school (if it is one of our partner schools)?

What days are you available to mentor in 2011?
(Include the times you are free from and till)

(It does not matter if you do not know your availability now as this can be confirmed at a later stage):

Outline your reasons for applying to the In2science Program:
 
Please give details of the skills and qualities that you will bring to the role: