2024 Bionics Institute Girls in STEM Mentor Form

1. Name

First Last

2. Email

3. Organisation

4. Organisation Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

5. My area of research / organisational specialty is:

6. I can attend an online briefing for mentors which will outline the expectations and how the program works (not mandatory, we can provide recording) on 22 May 2024 at 4pm.

7. My place of work would be interested in having our students visit during the program (date/time to be arranged between you and your school).

(This does not need to take place before the mentoring starts, it can be between May-Oct)

8. I commit to delivering five online mentoring sessions to my students of approx 30 minute duration between June and October and providing instructions for Google research to be discussed in each session.(Required)

Please note, you cannot participate in this program without agreement to this statement.

9. I am interested in attending a Girls in STEM Certificate Presentation event which will take place in October 2024.

Venue TBC but likely to be held in the Melbourne CBD.

10. All mentors must supply a Working With Children Check for Volunteers to participate in this program. Please upload your proof of current WWCC here.

Max. file size: 50 MB.

You will require a volunteers Working with Children Check. We will accept proof of WWCC submission or a photo of the card.

If you do not have a current WWCC, apply here: Work with Children’s Check

Privacy

All information in relation to this program will be handled in accordance with the Bionics Institute Privacy Statement.

11. I agree to the terms and conditions of the program(Required)

I agree to the terms and conditions of the 2024 Bionics Institute Girls in STEM program

I agree to be added to the Bionics Institute database and receive newsletters via email.

I authorise the Bionics Institute to take, edit and use information, photos, audio clips and video clips of me for marketing purposes (print, online, external sources).

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2024 Bionics Institute Girls in STEM Mentor Form

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