Topic Representative Registration

Before completing this form, please ensure you have spoken to your Topic Coordinator and agreed on your intention to work together this semester. If you are applying for two topics, please fill in the form separately for each topic (i.e. you complete the form twice). Students can hold a maximum of two Topic Representative positions each semester.

Name*

First Last

Student ID Number*

Flinders Email*

Enter Email Confirm Email

College*

There are Topic Representatives in topics in the College of Science and Engineering and the College of Medicine and Public Health.

Topic Code*

Please only enter one topic code. If you are registering for multiple Topic Representative positions, complete a new form for each topic.

Topic Coordinator Name:*

Topic Coordinator Email*

Tutor/Lecturer Name

Have you previously undertaken student representative training with FUSA?

Yes
No
Unsure

Submitting this form
A copy of this form will be sent to your Topic Coordinator and FUSA student representation support staff. FUSA will then contact you regarding Topic Representative training once approved.

FUSA Use of Information
I understand that FUSA will make my name and email available to my Topic Coordinator and to other Topic Reps on the Student Rep Space for communication and information support purposes. I also understand that the Privacy Act 1988 (Commonwealth) applies to this information and that I can access or change it at any time at the FUSA office.

I understand that my details will be used for the purposes listed above.

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