IncLUsion student buddy - registration form

You can use this form to register as an IncLUsion student buddy.
At present, IncLUsion courses are offered by the faculties of Humanities, Law, Science, Social Sciences,
FGGA and Law, and the Academy of Creative & Performing Arts. We are therefore primarily looking for
buddies from these faculties. However if you are studying at a different faculty, you are also welcome to register.
We hope to extend the range of IncLUsion courses in the future.

Full Name *

e-mail address *

Student number *

Umail address (for online meetings via Teams) *

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 *

Which languages do you speak (indicate
proficiency level) *

When do you want to participate in the buddy
system? *

Entire semester

Other: state dates

We generally match 2 to 3 buddies to a small
group of students. If you have a friend who is
also registering as a buddy, let us know their
name and we will try to assign you to the
same buddy team (not guaranteed).

Is there anything we should take into
account when selecting your buddy team?

If you have any questions, 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

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: communicatie@sea.leidenuniv.nl

* = Input is required