You must be a student studying at any Australian University at an undergraduate level or above to be eligible to register to use the CUC Snowy Monaro.

Upon submitting the below form, staff will contact you during business hours to complete the registration process.

Name *

Name

First Name

Last Name

Preferred Name

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth *

Date of Birth

YYYY

Email Address *

Phone *

Phone

(###)

###

####

Emergency Contact *

Emergency Contact

First Name

Last Name

Phone 1 *

Phone 1

Emergency contacts number

(###)

###

####

Do you have a pre-existing injury or medical condition/disability that CUC Snowy Monaro Staff meed to be aware of? If so, please provide details: *

Do you identify as Aboriginal or TSI heritage? *

Does your family speak another language other than English at home? If so, please specify: *

Has any member of your immediate family completed a University degree? *

What is the highest level of education you have completed? *

Course Information

University *

Course *

Level of study *

Student ID *

Current Subjects *

Policy *

I wish to register for use of the CUC Snowy Monaro. All of the information I have provided to CUC Snowy Monaro is true and correct.

Decline

I have read, understood and agree to: *

Please view via T's & C's page

the Terms of Use Policy

the Network Use Policy

the Swipe Card Use Policy

receiving marketing material and communications from the CUC Snowy Monaro

Date completed *

Date completed

YYYY

Register