Begin your expression of interest

Instructions
For privacy reasons, the following forms should be filled out by either the applying student, or in their immediate presence.
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Rotary Zone 8

Eligibility to apply

To determine if you are eligible to apply for the NYSF, please complete the following details:

Are you currently enrolled in Year 11 at school?: yes   no
Are you an Australian citizen, permanent resident,
and/or currently enrolled in Year 11 in Australia?
yes   no
Rotary district:

To be eligible to attend the National Youth Science Forum January Sessions you must be an Australian citizen, permanent resident, and/or currently studying in Australia in Year 11. If you do not meet these criteria you are unfortunately not eligible to attend the NYSF January Sessions.

Expressions of interest can only be submitted through one Rotary District, and are limited to one Rotary Club within that District. Failure to comply with this may result in termination of the expression of interest.

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Personal details

Your name should be entered in propercase (ie. lowercase with the first letter capitalised). Also, please enter your name as it would appear on official documents such as a passport or license (ie. no abbreviations or nicknames). You will have the chance to enter your preferred name later. For example, if your name is “Johnathan Frederick McSmith”, please enter it as such, rather than “johnny frederick mcsmith” or “FRED MCSMITH”, etc.

first name: middle name(s): last name:
d.o.b.: (dd/mm/yyyy) gender: male   female
email:
email (repeat): (double-check that your email address is correct, since your username and password will be emailed to this address)
Do you identify as a person with a disability? yes   no   prefer not to say
Do you identify as an Aboriginal and Torres Strait Islander? yes   no   prefer not to say
Please indicate any languages other than English spoken at home:
  ArabicCantoneseFrenchGerman
  HindiIndonesianItalianJapanese
  KoreanMandarinPolishPortugese
  RussianSinhaleseSpanishTagalog
  UrduVietnamese
  other (please specify)

Please note: If you fail to receive your login details within 60 minutes please (a) check the spam/junk folder in your email account, or (b) call the NYSF office (02 6125 2777) to be given login information

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Home address details

Please enter your home address details. If your term address is different to your home address, you will have the opportunity to enter it later.

address (line 1):
address (line 2):   (only use if your home address requires extra description)
suburb/town: state: postcode:
country: Australia
home phone: (include the area code)
mobile phone: (only enter if you have a personal mobile phone)
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Next of kin details

Please enter your next of kin details. This should usually be one of your parents.

relationship to you:   (select from the list, or enter a custom value)
title: first name: last name:
email:
mobile phone:
address (line 1):
address (line 2):   (only use if your next of kin’s address requires extra description)
suburb: state: postcode:
country:Australia
home phone: business phone:

If you need to enter a second emergency contact, you can do so here.

relationship to you:   (select from the list, or enter a custom value)
title: first name: last name:
email:
mobile phone:
address (line 1):
address (line 2):   (only use if your second emergency contact’s address requires extra description)
suburb: state: postcode:
country:Australia
home phone: business phone:
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Endorsing Rotary club

The Rotary Club where you submit your expression of interest will, if you are successful, become the Club that endorses your expression of interest. If you know the name of this Rotary Club, please select that Club in this section. If you do not yet have a Rotary Club, please continue with your Expression of Interest. Your Rotary District Chair will assist you in finding a supporting Rotary Club.

Rotary district:
sponsoring Rotary club:
All Rotary clubs in your District
club nameaddress

Register your details

You are now ready to register your expression of interest for the 2018 NYSF. If you wish to change any of your details before proceeding, please navigate through the tabs and alter your entries as appropriate.

privacy: I agree that my contact details can be provided to NYSF Partners if required. Specifically this would be for arranging security clearance on site visits.
session preference: no preference

You can indicate a session preference but as numbers at each session are limited we can’t guarantee placement. We can guarantee that irrespective of which session you attend access to the widest array of science and engineering will be available.

Where did you hear about the NYSF: (tick more than one box if applicable)
Presentations at school by Rotary
Presentation at school by former NYSF student (their school)
School science teacher
Presentation at school by former NYSF student (school other than theirs)
Postcard in local venue
Shared Facebook post
Facebook ad
National media item
Local media item
Recommendation by friend or family
Search engine
Australian Science Teachers Association information
The UQ Science Ambassador scheme
Work experience coordinator
The Science Experience 2017
Teacher not at my school
Family friend
Personal friends other than former NYSF students
Duke of Edinburgh scheme
Young Scientists of Australia
Other science programs
Other (please specify)

Register me

Further information