PASS Peer Facilitator Application Form: 2016 team recruitment
Family Name
First Name
Telephone (Mobile)
Preferred Name
Telephone (Alternative)
Gender
Female / Male
USyd Email Address:
Citizenship
Visa number and expiry
(For international students)
Date of birth (DD/MM/YY)
Unikey
Course (E.g., B.Ec):
Student ID (SID)
What was the first semester and year of enrolment into your current degree?
S1 or S2
Expected MONTH and YEAR of degree completion
Month:
Year:
Year:
Semester Postal Address
Permanent Postal Address
(If different to your semester postal address—we need this to send any training materials to you during the Summer break, should you be successful)
Please indicate which units you would like to apply for and the year you completed the unit/will complete: Rather than ticking boxes, please write “1, 2, 3 …” in the boxes in the order or your preferred units to work in.
ACCT1006
Year:
Lecturer:
ACCT5001
Year:
Lecturer:
ACCT2012
Year:
Lecturer:
ACCT6001
Year:
Lecturer:
BUSS1001
Year:
Lecturer:
ACCT6010
Year:
Lecturer:
BUSS1002
Year:
Lecturer:
BUSS5000
Year:
Lecturer:
BUSS1020
Year:
Lecturer:
BUSS5001
Year:
Lecturer:
BUSS1030
Year:
Lecturer:
BUSS5002
Year:
Lecturer:
CLAW1001
Year:
Lecturer:
CLAW5001
Year:
Lecturer:
INFS1000
Year:
Lecturer:
FINC5001
Year:
Lecturer:
FINC2011
Year:
Lecturer:
QBUS5001
Year:
Lecturer:
FINC2012
Year:
Lecturer:
1. I have achieved a “Distinction” or “High Distinction” grade in the Unit(s) of Study I am applying to facilitate in and a “Credit” grade average overall
Yes No
2. I can attend the 3 days of training (February 16th, 17th, 18th, 2016)
(attendance is compulsory if you are to be considered for a PASS Facilitator role)
Yes No
3. I can commit to working for the full year
Yes No
4. I have attended PASS sessions
Never
1-4 times
5 or more time
If you have attended PASS sessions, list approximately how many sessions you have actually attended in each unit of study:
7. I have applied for the: Please tick
1. 2015/2016 Summer Industry Placement Program
2. 2016, Semester 1 Industry Placement Program
3. Washington DC Placement
4. L.A. Placement
5. China Placement
6. None of the above
