To join Momentum Program for free, please supply the following details about yourself. You must fill in every section that is marked with an asterisk (*).

Privacy and Code of Conduct Disclaimer: Personal information collected on this form or supplied by you will be treated in accordance with the Privacy Act 1988 and any relevant guidelines. The information collected is used for the purpose of managing Momentum Mentoring Program at UOW. All information shared during the Momentum Mentoring Program is private and confidential.

Please note that by submitting this form, you agree to comply with the Rules for Student Conduct & Discipline while participating in the program. All Momentum Program participants have to respect the diversity of members of the campus community and are required to conduct themselves in an orderly and proper manner as outlined by University rules.

WUPA, WUSA and UOW disclaim responsibility for any accidents or misfortunes which may occur during the Momentum sessions, meetings or off-campus activities.