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Application for Future Research Leaders Program 2013

Please complete this registration form if you have been contacted by your faculty and invited to do so.

Modules 2013 - Semester 1

 

 

 Module 1 - Wednesday 20 March, 9am - 2.30pm
 Module 2 - Monday 25 March, 9am - 3pm
 Module 3 - Thursday 4 April, 9am - 2.30pm
 Module 4 - Monday 8 April, 9am - 3pm
 Module 5 - Friday 19 April, 9am - 4.30pm
 Module 6 - Wednesday 24 April, 9.15am - 1pm
 Module 7 - Thursday 2 May, 9am - 4.30pm
 Module 8 - Thursday 9 May, 9am - 2.45pm
Staff ID Number:
Title:
First name:
Surname:
Gender: Female
Male
In what year did you submit your PhD?
Position Title:
Department:
Faculty:
Campus/site:
Email address:
Phone number:
Mobile number:  *Optional
Dietary Requirements:
Payment details:
Payment details must be completed
to confirm registration.
1. Cost centre and fund: Account Code:
 Cost Centre
 		Fund:
2. Debtors Invoice for Departments not on SAP

Payment and Cancellation Policy

All modules are free of charge, however, payment details must be entered as cancellation fees apply ($125 per module) where two weeks notice of inability to attend is not received. Payment details must be completed to confirm registration. No refunds are given.

The information on this form is collected for the primary purpose of processing your application to attend a Leadership & Management Development Program. Other purposes may include communicating with you, program administration, and reporting and de-identified statistical analyses. You have a right to access personal information that Monash University holds about you, subject to any exceptions in relevant legislation. If you wish to seek access to personal information or inquire about the handling of your personal information, please contact the University.