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IPEP 2022 Membership
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Student Number (Unimelb students only)
*
Your answer
Unimelb Course (Discipline)
*
Dentistry
Medicine
Optometry
Physiotherapy
Nursing
Audiology
Speech Pathology
Music Therapy
Public Health
Dietetics
Paramedicine
Are you an international student?
*
Yes
No
Which of the following best describes your association to the University of Melbourne
*
Choose
Graduate Student (Unimelb)
Honours Student (Unimelb)
Undergraduate Student (Unimelb)
Faculty Member (Unimelb)
Student from another University
Speaker/Health Professional
External Organisation
Are you over 18 years of age?
*
Yes
No
Year Level
*
1
2
3
4
NA
Expected year of Completion
Your answer
I give my consent to join as a member of IPEP-HSN
*
Yes
No
I give my consent for photos of me to be taken during events and potentially uploaded on social media platforms e.g Facebook
*
Yes
No
I give my consent to receive information about upcoming events via email.
*
Yes
No
Do you have any ideas or recommendations for IPEP? Your feedback is greatly appreciated.
Your answer
Submit
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