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Registration for mentors and mentees for participating in the Peer-Mentoring Programme for students with disabilities, chronic or mental illnesses.

This registration/application form supports us to select the participants and tandems. Please fill in your answers thoroughly. If you have any questions please contact:

zab-studienstart@uni-bielefeld.de

Name*

First name*

Date of Birth*

E-mail*

E-mail repeat*

I would like to participate as a mentor/mentee.

Do you have kids or do you look after relatives in need of care?

Gender

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Are you new in Bielefeld?

What are you studying?*

In which semester are you in the next semester?

What are your expectations of the peer mentoring programme?*

What questions related to your studies do you bring to the programme?

What do you expect from your tandem partner?*

Can you imagine speaking German in tandem?*

Yes

No

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I request the following

Bitte wählen Sie aus:

Ich habe keinen Bedarf

Written documents

in large print

digital

Braille

The following communication aids

Sign Language (please tell us which sign language)

Palantypist (Speech to Text Reporter)

FM system

I will be accompanied by

Personal assistance

Guide dog/assistance dog

Further requirements, comments and wishes (e.g. size of the group, special requirements for the room, seating near the door, etc.)

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Data protection regulations

I hereby declare my willingness to actively and committedly participate in the “AccesAbility” - peer mentoring programme.*

I hereby consent to the processing of my personal data as described in the privacy policy.

Consent is voluntary and can be revoked at any time with effect for the future. The consent is voluntary and can be revoked at any time with effect for the future. The data processing prior to your revocation remains lawful (please contact the professional contact person for this - see data protection declaration). In the event of a revocation, the personal data will be deleted immediately. The revocation does not no disadvantages to you. Legal permissions remain unaffected by a revocation of consent.*