Aspiring STEM Specialists - Registration Form

STEP 1 - NAME AND DETAILS

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* 1. Enter your full school name (e.g. Example State School).

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* 2. Enter your name and details.

First Name

Last Name

Email Address

Phone Number

Job Title/Teaching Area

Dietary Requirements

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* 3. Enter the name and contact details of your school's principal. Skip if listed above.

First Name

Last Name

Email Address

Phone Number

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* 4. Option 1: If you are registering yourself only, scroll to the bottom of the page and select "Next".

Option 2: If you are registering up to 4 additional members from your school or cluster, move through Question 6 onwards and enter their details. When complete, scroll to the bottom of the page and select "Next".

Option 3: If you are registering a larger group, please email a list through to Katie Ellard at the IMPACT Centre (kella2@eq.edu.au). Scroll to the bottom of the page and select "Next".

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* 5. Register an additional member of Aspiring STEM Specialists from your school (or they can register themselves).

First Name

Last Name

Email Address

Phone Number

Job Title/Teaching Area

Dietary Requirements

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* 6. Register an additional member of Aspiring STEM Specialists from your school (or they can register themselves).

First Name

Last Name

Email Address

Phone Number

Job Title/Teaching Area

Dietary Requirements

Question Title

* 7. Register an additional member of Aspiring STEM Specialists from your school (or they can register themselves).

First Name

Last Name

Email Address

Phone Number

Job Title/Teaching Area

Dietary Requirements

Question Title

* 8. Register an additional member of Aspiring STEM Specialists from your school (or they can register themselves).

First Name

Last Name

Email Address

Phone Number

Job Title/Teaching Area

Dietary Requirements