Membership Form - Forging United and Safe Environments

Complete an application form to become a member today.

Name Name First Last
What are your pronouns?

What are your pronouns? She/her He/him They/them Other Other
Email contact
What area do you best represent?
Which area of the University do you work in?
School/Division/Other
If other
What area of the University are you currently enrolled in?
Which industry do you best represent?
Have you completed any training and /or courses that may be relevant to support your role on the Network?

Have you completed any training and /or courses that may be relevant to support your role on the Network? Yes No
Please list the training and/ or courses you have completed
Acknowledgement

Acknowledgement I agree to complete and engage in training resources provided by the FUSE Working Group I agree that upon completing my membership and training that I will take a stand to prevent harm and forge an environment that is anti-racist and anti-discriminatory, thus valuing, celebrating and showcasing cultural diversity. I will take action in my daily life, wherever I feel confident and safe to do so, to ensure that all spaces are culturally safe and inclusive.
Data collection statement

All data will be held securely by the Indigenous Strategy Unit and will be stored in a password protection folder on UOW’s share drive. We may use this data to inform our strategic direction using non-identifiable information.