Please complete the following form to apply for a place on a 5-Day SPARQ-ed Immersion

Student Details

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* 1. Contact details

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* 2. School attended

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* 3. Year level

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* 4. Gender

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* 5. Date of birth (note you must be 15 years old at the time of the Immersion to participate)

Date

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* 6. Student alternative email address

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* 7. I wish to identify as:

Select Program Dates

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* 8. Program dates
All dates are subject to research teams availablility, project topics, and will be confirmed during first term 2018.

  1st choice 2nd choice 3rd choice
2018:  9-13 April (Commonwealth Games week)
Years 11 and 12 only
2018:  2-6 July
Years 10, 11, 12
Residential regional and remote student Immersion (min age 15 years) - accommodation UQ College
2018:  9-13 July UQ special event
Years 10, 11, and 12
Residential regional student Immersion (min age 15 years) - accommodation UQ College
2018:  17-21 September (Last week of term 3)
Years 10, 11, and 12
2018:  24-28 September
Years 10, 11, and 12
2018:  2-5 October
Years 10, 11, and 12
2018: 3-7 December
Years 10 and 11 only
2018: 10-14 December
Years 10 and 11 only
Parent Details

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* 9. Parent/Guardian Contact Details

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* 10. Parent/Guardian contact phone number

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* 11. Parent/Guardian email address

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* 12. Fees are payable by the parent/guardian via credit card. At the end of this application a link will be provided requesting credit card details. A non-refundable $50 administration fee will be charged to the credit card prior to commencement of the immersion. This will be deducted from the total cost of attendance. The final costs will be charged after attending the course.

I hearby give permission for my child to take part in the SPARQ-ed Research Immersion Program. I understand that there is a fee associated with this program and that they are the responsibility of the student unless a prior arrangement has been made with the school to cover the costs.

School Details

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* 13. Contact teacher details (teacher you will ask to write a character recommendation)

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* 14. School information

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* 15. School type

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* 16. School Location

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* 17. Subject #1

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* 18. Subject #2

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* 19. Subject #3

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* 20. Subject #4

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* 21. Subject #5

SPARQ-ed Bonus Rank Program (Optional)

The SPARQ-ed Bonus Rank Program allows participants in the research immersion programs to complete an additional component which awards them a bonus point under the University of Queensland Bonus Rank Scheme. Information about this program can be found at http://www.di.uq.edu.au/sparqedbonusrank

I have read the information about the SPARQ-ed Bonus Rank Program and am aware of the additional activities required of me. I would like to take part in this optional activity and be considered for a bonus point under the University of Queensland Bonus Rank Scheme.

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* 22. I would like to take part in the optional Bonus Rank Program

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* 23. If Yes: Learner Unique Identifier (LUI):

Student Interest Statement (max 500 wds)

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* 24. Please write a short statement on what qualities you can bring to the SPARQ-ed Research Immersion Program, citing examples where possible. Explain why you want to take part in the program and detail any areas of special scientific interest you may have:

Activity Log

Please detail any relevant scientific experience you may have already completed. This may include part-time work, work experience, volunteer work, and other science programs (e.g. Siemens Summer School, Frontiers in Science lectures, Optiminds, Science & Engineering challenge, Science Competitions etc.).

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* 25. Activity #1

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* 26. Activity #2

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* 27. Activity #3

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* 28. Activity #4

Thank you for your expression of interest. You will be given an opportunity to apply for your preferred Immersion before it is opened up to other students.

Please note: You will still need to meet the academic achievement requirements to be considered by the selection panel.

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