Application form Incluusion Buddy Support

PERSONAL INFORMATION:

First Name: *

Last Name: *

Gender: *

Male

Female

Prefer not to say

Other

Date of Birth: *

Phone number: *

Email address: *

STUDY INFORMATION:

Level: *

Study Programme: *

Department or Faculty: *

LANGUAGE SKILLS:

What languages do you speak? *

PARTICIPATION IN THE BUDDY SUPPORT:

For which block would you like to apply?
You can select multiple options if you want to.
If you are unsure about your participation in the future, you can just select the upcoming block. *

Block 1.

Block 2.

Block 3.

Block 4.

We always make small groups of at least two buddies and one or more Incluusion students.
If you sign up as a buddy with a friend, you will be matched together.
If you sign up on your own, we will take care of the matching,
unless you let us know any preferences at the end of the speed-friending event.

Would you like to sign up together with a friend? *

Yes

Namely:
(indicate name and email address of your friend)

Can you briefly explain why you would like to volunteer as a buddy?
We are just curious about your motivation, so max 200 words

Taking your studies and private life into account, are you able to commit at least 2 hours per week?
Mostly communicating via Whatsapp/Signal and meeting up around once every two weeks. *

Are there any criteria that should be taken into account when matching you to the other students? *

Do you have any questions or comments?

DECLARATION:

I agree that my personal data submitted here may be electronically processed and stored,
exclusively for the organisation of the buddy support system. *

For more information on how Utrecht University handles personal data, please refer to our privacy statement.

* = Input is required