Fieldwork Information & Indemnity sheet

Family Name: .............................................................. (as in your passport)

Given Name(s): ........................................................... (Title (Mr/Ms) ...........

Address during term: ....................................................................................

................................................................. Telephone: ...................................

Date of Birth: ....................................... Citizenship: ...................................

Issuing Country and Passport Nº: ................................................................

Any other information the fieldwork coordinator should know?:

........................................................................................................................

........................................................................................................................

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I hereby indemnify The University of New South Wales and its employees against any claim for damages, whether direct or consequential, arising from my enrolment and/or participation in the subject SOCA2204 or the subject GENT1205 and the fieldwork in the Solomon Islands associated therewith.

Signed:...................................................... Date: ..............................

NB: Please return this Information Sheet to the fieldwork coordinator:

Grant McCall

School of Sociology

University of New South Wales

Sydney NSW 2052

Telephone: 9385–2408 • FAX: 9313–7859 • e–mail: g.mccall@unsw.edu.au