The information on this form is being collected by the College of Health & Medicine, Australian National University (ANU). The information is being collected, with your consent, in order to complete your registration for the ‘Global Mentorship & Support program for COVID Health Professionals’ initiative. The information will be used by authorised staff for the purpose for which it was collected, and any other purpose which you have expressly consented to. You can withdraw your registration any time by contacting jay.poria [at] anu.edu.au. If you do not provide all the information that is requested on this form, it may not be possible for us to ensure appropriate arrangements for your participation in this initiative.
The ANU is committed to protecting personal information provided by you in accordance with the Privacy Act 1988 (Cth) and the information will be protected against unauthorised access and use.
You may access or request correction of any personal information you have provided to ANU by contacting email@example.com.