Teacher Referral
Your Details
Your name
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Prefix
First Name
Last Name
Your email address
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Your phone Number
*
Format: 00-0000-0000.
School Name
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School State
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Please Select
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Student Details
Student name
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First Name
Preferred Name
Last Name
Year level in 2025
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Year 8
Year 9
Please provide comments in relation to the student’s effort and application
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Example, are they inquisitive, how do they display a positive attitude to learning, etc?
Please provide comments in relation to the student’s social skills and maturity
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Example, do they usually get along well with other students, are they a team player, are they likely to share their experiences back at school in a positive way (e.g. talk about it in assembly), etc.?
In your opinion does this student have the maturity and willingness to engage productively with a STEM Coach?
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As part of the program, students will be matched to a professional female working in the STEM industry.
Do you feel this student has the determination to commit to this program, including a December residential camp and a July virtual camp, as well as regularly connecting with their STEM Coach?
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Do you think the student can sustain their focus over an extended period (i.e. can they complete a project)?
Please provide comments in relation to barriers to learning this student may face, or special assistance they may require, if invited to attend
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Barriers may relate to be physical, financial, or social needs.
Please provide any other relevant comments about this student.
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