2024 Science Ambassador Nomination

UQ Science Ambassador Program

Student Nominations

The Faculty of Science is accepting nominations for the UQ Science Ambassador Program 2024!

Please note that only teachers (with the support of the principal) may nominate students to participate in the UQ Science Ambassador Program.

If you are a parent, guardian, or student please note that we cannot accept individual nominations. If your school does not currently offer the UQ Science Ambassador Program, we highly encourage you to reach out to your science teacher and request that they register your school for the program.

Instructions

Step 1: Download and complete a UQ Science Ambassador consent form for each student you are nominating.

Step 2: Complete this online nomination form.

Note: The form below can be used to nominate up to ten students. If you need to nominate more than ten students, or have further students to add after your first batch of nominations, please submit this form again (ensuring your school name is entered identically).

This program is designed for Year 11 students. Interested Year 12s are also eligible, but should make an informed decision about participation and how much time they can reasonably commit alongside study.

Nominations close end March 2024. The program begins Term 2 2024.

For more information, please contact sciamb@uq.edu.au.

Part A – School Information

We will use your school's mailing address to send the Science Ambassador blazer badges.

Official School Name*

School address (excl. postcode)*

State*

Postcode*

Part B – Science Ambassador Teacher Information

Enter the details of the teacher who will be the key contact for the Science Ambassador Program at your school. You may also optionally enter details of another teacher who will be involved in the program.

Please check email addresses carefully as this is the only means of communication we have with you.

Title* (required)
	e.g. Dr, Mrs, Ms, Mr, Mx etc.

First (Given) Name*

Last (Family) Name*

Email*

Secondary Email
	e.g. shared department or role inbox

Role in School*

Additional Teacher Title

Additional Teacher First (Given) Name

Additional Teacher Last (Family) Name

Additional Teacher Email

Additional Teacher Role in School

Part C – Science Ambassador Nominations

Please note that you must provide a completed and signed consent form for every student nominated below. We cannot consider student nominations without a corresponding consent form.

Please check email addresses carefully as this is the only means of communication we have with your students.

Student 1: First (Given) Name*

Student 1: Last (Family) Name*

Student 1: Email*

Student 1: Consent form* (required)	(Maximum size: 15 MB )
	If your combined file size is too large, please send via email to sciamb@uq.edu.au.

Student 2: First (Given) Name

Student 2: Last (Family) Name

Student 2: Email

Student 2: Consent form	(Maximum size: 15 MB )
	If your combined file size is too large, please send via email to sciamb@uq.edu.au.

Student 3: First (Given) Name

Student 3: Last (Family) Name

Student 3: Email

Student 3: Consent form	(Maximum size: 15 MB )
	If your combined file size is too large, please send via email to sciamb@uq.edu.au.

Student 4: First (Given) Name

Student 4: Last (Family) Name

Student 4: Email

Student 4: Consent form	(Maximum size: 15 MB )
	If your combined file size is too large, please send via email to sciamb@uq.edu.au.

Student 5: First (Given) Name

Student 5: Last (Family) Name

Student 5: Email

Student 5: Consent form	(Maximum size: 15 MB )
	If your combined file size is too large, please send via email to sciamb@uq.edu.au.

Student 6: First (Given) Name

Student 6: Last (Family) Name

Student 6: Email

Student 6: Consent form	(Maximum size: 15 MB )
	If your combined file size is too large, please send via email to sciamb@uq.edu.au.

Student 7: First (Given) Name

Student 7: Last (Family) Name

Student 7: Email

Student 7: Consent form	(Maximum size: 15 MB )
	If your combined file size is too large, please send via email to sciamb@uq.edu.au.

Student 8: First (Given) Name

Student 8: Last (Family) Name

Student 8: Email

Student 8: Consent form	(Maximum size: 15 MB )
	If your combined file size is too large, please send via email to sciamb@uq.edu.au.

Student 9: First (Given) Name

Student 9: Last (Family) Name

Student 9: Email

Student 9: Consent form	(Maximum size: 15 MB )
	If your combined file size is too large, please send via email to sciamb@uq.edu.au.

Student 10: First (Given) Name

Student 10: Last (Family) Name

Student 10: Email

Student 10: Consent form	(Maximum size: 15 MB )
	If your combined file size is too large, please send via email to sciamb@uq.edu.au.

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