IncLUsion language buddy - registration form

You can use this form to register as an IncLUsion language buddy.

Note that there is seperate form for the IncLUsion student buddy programme.

Full Name *

e-mail address *

uMail address
(for online meetings in Teams) *

Student number *

Mobile phone number (note: this may
be provided to IncLUsion participants) *

Address *

Gender *

Study programme *

Faculty and department *

Programme type *

Bachelor

Master

Current year of study *

What is your level of Dutch?
Beginner, intermediate, advanced, fluent

Do you have any previous experience in teaching, tutoring
or language exchange? *

Yes

If yes, please elaborate

Are you available to take part in language cafe
sessions every 2 to 3 weeks? *

Yes

If not, how often are you available?

Do you have a preference for a day or time
for language cafes? *

Is there anything we should take into account
during your language buddy application?

Would you be available to attend the buddy introduction
on December 3rd from 17.30 to 18.15? *

Yes

Are you available to attend kick-off day during
the week of January 25th–31st? *

Yes

If you have any questions about the role,
please enter them here

Would you be interested in doing
other (organisational) activities for
the IncLUsion programme? If so,
the IncLUsion team may contact
you about this in the future.

Nee

How did you find out about the IncLUsion buddy programme? *

Through social media (Instagram, LinkedIn, Facebook)

Via friends or fellow students

Through PR around the university (screens, posters, flyers)

Other, namely…

By submitting this form, I agree that the personal data I enter here may be electronically processed and stored
exclusively for IncLUsion programme organisational purposes. I understand that I may request the deletion of
my data at any time and without any given reason by sending an email to: studentencommunicatie@leidenuniv.nl

* = Input is required