Kindly complete and submit this form to Stella Musungu (HAICU offices @ 28 Rhodes Avenue, Next to Student Wellness Services) OR via email by Friday 29rd September 2017.

ACEs 2018 application form

Please complete all sections of this form

Personal Details

Name: …………………………………. Surname………………………………………………..

Sex (please indicate with a tick):

Date of Birth: ……………………………………… Age: …………………………………

Student Number: ………………………………… Faculty: …………………………..

Degree: ………………………………………………………………..Current Year of Study…………………….

Nationality: …………………………………………..Intended period of study at UCT: ………………..

UCT Term-Time Contact Details

Residential Address: ………………………………………………………………………………………………..

Cellphone: ……………………………… E-mail address: …………………………………………………………

Vacation-Time Contact Details

Residential Address: ………………………………………………………………………………………………..

Cellphone: ……………………………..E-mail: ……………………………………………………………………

Best method of contact whilst on vacation……………………………………………………………..

Interest in joining the 2018 ACES programme: In not more than 20 lines, please

a) Motivate why you would like to take part in the 2018 ACEs programme?

Start writing here (Max 20 lines):

b) What is your understanding of inclusivity at UCT?

Start writing here (Max 20 lines)

c) If you were tasked with organising a small workshop (20 people), in the residences around gender-based violence, how would you go about organising it? For example what messages would you communicate, who would you involve, and what activities would you include?

Start writing here (Max 20lines)

General questions about availability (Please tick the option that best suits you)

1. One of the first duties for an ACE in 2018 is conducting orientation workshops for first years. This requires you to come back early in January 2018 on a date to be advised. Would you be able to come back to campus early before orientation starts?

Yes No

2. Are you part of the 2018 Orientation training programme?

Yes No

3. Will you be attending summer school?

Yes No

4. Are you part of a House Comm or any other programme that will require your assistance during O-week 2018?

Yes No

5. After the 3 week orientation programme, the ACEs meet once a month on a selected evening (5-7pm).They also meet for 1 training day on a Saturday in March and August. Would your academic timetable allow you to attend these meetings?

Yes No

6. If selected, part of the ACEs programme requires that you attend the first training on 14th & 15th October 2017. Are you available to attend the training on these dates on both these days?

Yes No

Thank you for completing this form.

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