Mentoring Service Preferences and Data Processing Agreement

Swansea University Mentoring Service
Mae'r holiadur hefyd ar gael yn Gymraeg drwy ddewis 'Welsh (Cymraeg)' o'r ddewislen uchod.
Welcome to the Swansea University Mentoring Service. The university employs a team of Specialist Mentors who are there to support you so that you may achieve your full academic potential. 
In order to access the service effectively, we need to know a little about you, such as your preferences for when and where you would like to receive mentoring sessions. We also require some important safeguarding information such as your location, emergency contact, and your G.P.'s details. Information on why we collect this and how your data is stored is detailed in the Inclusive Student Support Services' privacy statement.
As the cost of the mentoring sessions are covered by your funding body, we also require you to review the Student Handbook attached to the initial email sent to you and agree to the terms set out. We use an online invoicing service called Clearlinks Connect which allows us to recover the cost of mentoring from your funding body, and in turn, pay the mentor for their time. Prior to being able to access the mentoring service we require your agreement that you will:
- Register for a Clearlinks Connect account prior to having a mentoring session. The link to register will be sent following the return and review of this form.
- Authorise the Mentor’s timesheets on the Clearlinks Connect system within 72 hours of the meeting.
- Acknowledge that the failure to authorise two consecutive timesheets could result in a temporary suspension of Mentor support.
- Acknowledge that if you fail to attend, or cancel a mentoring session with less than 24 hours notice on two occasions during a term, mentoring support will need to be suspended. Mentoring will become available again at the start of the next new term. 
Finally, the Mentoring Service is audited annually to ensure that we are providing support in a manner compliant with your funding body. Your funding body requires your consent so that your information may be used in these audits. Please refer to the information on Page 4 and indicate whether or not you agree to the data processing required to be included in an audit.

Mentoring Preferences
Please provide the below details to assist us with assigning you a Specialist Mentor.
Please select how you would like to receive support. You can select more than one*
In-person (face to face)Remote Support (provided via phone/zoom)Combination of the two (in-person and remote)
Please note, due to high demand we currently have limited capacity for in-person support. Please let us know if you are able to try remote support as this will help us with allocation. You can select more than one option above.
If you have selected ‘In-person’ from the question above, which campus would you like to receive your support? You can select more than one option:
Singleton CampusBay CampusSt David's (Camarthen)
Do you have a preference for the gender of your mentor? Please note, we cannot guarantee that we can provide you with your selected choice due to service demand:
MaleFemaleEither
Please provide the most suitable days for you to receive mentoring. Please note this cannot be guaranteed and it is expected you will be flexible when accessing mentoring. If you do not yet know your timetable, please state not known.
Please provide the most suitable days for you to receive mentoring. Please note this cannot be guaranteed and it is expected you will be flexible when accessing Specialist Mentoring. If you do not yet know your timetable, please state not known.*
Monday (Morning)Monday (Afternoon)Tuesday (Morning)Tuesday (Afternoon)Wednesday (Morning)Wednesday (Afternoon)Thursday (Morning)Thursday (Afternoon)Friday (Morning)Friday (Afternoon)Not known
My preferred method of contact is:*
Email (student email account only)PhoneOther
Please provide any other information you feel we should be aware of below:
Mentoring Agreement
Before completing the below section please ensure you have read and understood the Student Mentoring Handbook attached to the email from which you received this link and the Inclusive Student Support privacy statement.
If you require clarification regarding the student agreement, or any of the required terms, then please email nmh@swansea.ac.uk
Mentoring Terms
I confirm I have received and understood the Mentoring Student Handbook which includes the appointment cancellation and student complaints procedure.*
I confirm
I agree to review my workplan every three months.*
I agree
I am aware that following a mentoring session I must authorise the timesheets confirming the session on the Clearlinks Connect system within 72 hours of the meeting. I am aware that failure to authorise two consecutive timesheets could result in the temporary suspension of Mentor support.*
I confirm I am aware.
I am aware that should I fail to attend, or fail to cancel a mentoring session with more than 24 hours notice on two occasions during a single term, that mentoring support will need to be suspended. Mentoring will become available again at the start of the subsequent new term. *
I confirm I am aware.
Mandatory Information
Please be aware that we are unable to begin mentoring without details of your G.P., location or Emergency Contact. Forms without this information will be returned for completion.
INCLUSIVE STUDENT SUPPORT SERVICES PRIVACY STATEMENT
Data Processing Agreement*
By continuing with this form I acknowledge that I understand the terms for which my personal data will be processed as outlined in the privacy statement
Agreement for Wider Disclosure
If you have previously submitted a Student Support Form to another service within Wellbeing and Disability, any consent options you provided earlier will be replaced by the selections you make on this form.
Please ensure you re-select all individuals or departments you wish to give consent for, even if you have done so before. If you do not re-select a person or department previously included, this will be treated as a withdrawal of consent for that party.
For example, if you previously gave consent for us to contact your GP or a nominated person, you must select them again here; otherwise, we will no longer be able to communicate with them.
I give consent for relevant information about my support needs and adjustments to be shared with the following (please tick all that apply and give details where necessary):
Swansea University Academic faculty, Exams Office and information systems (such as specific details regarding your support).Swansea University support services e.g. Student Services, Hwb, Centre for Academic Success, Library, Occupational HealthSwansea University Facilities and Estates e.g. Residential Services, Security, Health & SafetyExternal support services e.g. Student Funding Bodies, specialist medical and/or mental health team, social servicesGP SurgeryNominated Contact (This can be a family member, guardian or responsible adult over the age of 18)Other
As you have provided consent to share information with external agencies, please supply any relevant details here, such as specialist medical and/or mental health team contact, social services:
External support services e.g. Student Funding Bodies, DSA Assessment Centre, specialist medical and/or mental health team, social services
G.P. details
Mandatory
Name of Doctor or Surgery*
Forms without this information will be returned
Address of your Surgery*
General Practitioner (GP) telephone number*
Nominated contact information
Mandatory
Please provide details of your Next of Kin or an alternative Nominated Contact (Forms without this information will be returned):*
First NameLast Name
Your contact's telephone number*
If this is an international number, please include the country code
Your contact's email address
example@example.com
Your details
Print Name*
First NameLast Name
Student Number (if known)
Your Telephone Number*
If this is an international number, please include the country code
Where are you staying? (If you are staying in Halls of residence, please also include your room number)*
Street Address
Street Address Line 2
CityCountry
Post CodeCountry
Signature*
Clear
Todays Date*
DayMonthYear
Date
Mentoring Service
Consent for Sensitive Personal Data Processing
In addition to the normal data processing carried out by Swansea University] ("the provider") the transfer of a copy of your DSA2 letter, study workplan, or other relevant information contained within your student record, to the Disabled Students Allowance Quality Assurance Group (“the Auditor”) may be required so that the Auditor can audit the provider’s internal processes for dealing with the delivery of non-medical help support. These audits play an important part of ensuring that the provider is complying with all relevant legislation, internal and external guidance. Such compliance is vital to the provider, so it can properly assess the delivery of this support.
The information that the provider is proposing to transfer to the Auditor is a copy of your DSA2 letter, study workplan, or other relevant information contained within your student record. As you will be aware, this includes the following Personal Data about you:
- Identity and age;
- Type of support awarded
- Timesheets confirming delivery of support
- Communications between you and the provider
- Higher education institution and course information.
The Centre is also proposing to transfer information which could be classified as sensitive personal data under the General Data Protection Regulations, including:
- the fact that you receive a disability allowance;
- letter of award of support;
- Timesheets which indicate the type of support being delivered
As the proposed transfer includes sensitive personal data (in this instance, health information about you), we require your consent before we are legally permitted to provide the Auditor with your sensitive personal data (but not other types of personal data), if selected as a student sample.
The personal data provided to the Auditor would only be processed for the specific purpose of carrying out the audit of the provider. The data would not be retained by the Auditor once the audit of the provider had been completed and accredited. This consent will be held by the provider for the duration of the audit process, alongside any other forms of consent you have provided to the provider in relation to other current data processing activities carried out by the provider in relation to your personal and sensitive personal data.
You are free to refuse to give your consent or to later withdraw your consent. Any refusal or withdrawal of consent will not affect any element of any service provided to you by the provider.
By signing this form and ticking each of the separate boxes below, you are giving your consent to the transfer of your sensitive personal data set out below from the provider to the Auditor and to the processing of this data by the Auditor for the purpose described above.
- The fact that you receive a disability allowance;
- Letter of award of support;
- Timesheets which indicate the type of support being delivered
Please select:*
I give consent to transfer the above types of personal data about meI do not consent to the transfer of the above types of personal data about me
Print Name*
First NameLast Name
Signature*
Clear
Todays Date*
DayMonthYear
Date
Should be Empty:

Swansea University Mentoring Service

Mentoring Preferences

Mentoring Agreement

Mentoring Terms

Mandatory Information

Agreement for Wider Disclosure

G.P. details

Nominated contact information

Your details

Mentoring Service