Express my interest – Student

If you’re a girl in year 9 and 10, are a passionate, high performer in STEM subjects and want to be considered for this program, then fill in the form below.

If you have any questions, please contact us.

Applications received are considered EOIs for the 2023-24 program for students in year 9 and 10 in 2023.

This program will begin in December 2023.

"*" indicates required fields

Your name*

First Last

Email address*

Please ensure this is a personal (non-school) email that is regularly checked

City*

State*

Are you of Aboriginal or Torres Strait Islander descent?*

Yes

Parent/Guardian name*

First Last

Parent/Guardian email*

Please ensure this is an email that is regularly checked

Parent/Guardian contact number*

If landline, include area code

School name*

Please indicate if you are home-schooled

School state*

Year level in 2023*

Year 9

Year 10

Are you receiving an Educational Scholarship to attend school?

Yes

If yes, please provide the name of your Scholarship

Are you a boarding student?

Yes

If yes, which city/town do you come from?

Please provide the name of your science or maths teacher*

If you are homeschooled, please provide the name of a personal referee

Prefix First Last Suffix

Your teacher's school email*

Or your referee's best contact email

Contact number for your teacher/referee or school office*

If landline, include area code