Aboriginal and Torres Strait Islander STEM Professional Award Application Applications close midnight (AEST) on Wednesday 3 November 2021. Application Process To apply please email to indigenous-stem-awards@csiro.au with the following attachments. •Application form | The applicant or nominator must complete: oPersonal information oPrivacy statement, oEligibility information, oSelection criteria and supporting evidence can be provided in written format or byvideo response to a maximum of four minutes •Referee forms | Referees must comment on the applicants’ suitability for the award •Annotated photos | Collated in 1-2 pages, max 6 photos per page in a word document orPDF. •Profile photo | To be used publicly if selected as a winner. Ideally the photograph shouldbe a close-up portrait from the waist up, in good light and with a simple background. Hereare some tips on taking profile photos. All applicants and nominators will receive confirmation their submission and be notified of their outcome after the judging period in November 2021. Any questions? Please contact the Awards team at indigenous-stem-awards@csiro.au or phone Scott Philip (03) 6232 5315 How to Apply For detailed instructions on how to apply please visit: https://www.csiro.au/en/education/Programs/Indigenous-STEM-Education-Project/Indigenous- STEM-Awards. Applicant Privacy Statement Use of personal and sensitive information provided by the applicant/nominator. Your personal information is protected by the Privacy Act 1988 (Cth) and CSIRO will handle your personal information in accordance with this Act. CSIRO is collecting your personal information, including your name, contact details and any responses to questions you provide to assess your eligibility to participate in the Indigenous STEM Awards, and to facilitate your participation in the program. CSIRO will also collect your personal and sensitive information from your profile photo, any video responses and school report/results for this purpose. If you do not provide your information you may not be able to participate in the program. The CSIRO Privacy Policy available at https://www.csiro.au/en/About/Access-to- information/Privacy outlines how your personal information will be handled, including details about how you can seek access or correction of the personal information we hold about you and how you can complain about a breach of the APPs and how CSIRO will deal with the complaint. If you require further information on how your personal information will be handled, please contact privacy@csiro.au. Do you (the applicant or nominator) consent to the collection and use of your personal information as set out in this privacy statement? Yes No Eligibility Information In order to be eligible for the STEM Professional award, the applicant must be able to answer ‘yes’ to the following questions: yes no Does the applicant identify as an Aboriginal and/or Torres Strait Islander person? Does the applicant hold a tertiary qualification? Does the applicant have endorsement from two referees? (one of whom is an Aboriginal and Torres Strait Islander person) Personal Information The following personal information is requested and must be completed for the application to be accepted. About You I am… nominating an applicant ☐ applying for myself ☐ (go to Applicant details below) Award category Early Career STEM Professional ☐ STEM Professional Career Achievement ☐ Nominator Details First Name: Last Name: Contact Phone: Email: Your relationship to the Applicant? Applicant Details First Name: Last Name: Preferred Name: Date of birth: Gender: Contact Phone: Email: Town: State: Postcode: Traditional Place name/Country on which you live (if known): Selection Criteria This is your chance to tell us about the applicant and why they should win the Award! Responses to each question should be at least a paragraph. The application assessment will be based on the following selection criteria. Please keep them in mind when completing the application and address how you/the applicant fulfil the criteria: • identify as an Aboriginal and/or Torres Strait Islander person • hold a tertiary qualification • be making significant contributions to key STEM initiatives, programs and/or research • demonstrate suitability and capacity to act as a role model for Aboriginal and Torres Strait Islander students, including examples of what the applicant has previously done as well as what they hope to do in this role. • be endorsed by two referees (one of whom is an Aboriginal and Torres Strait Islander person) NOTE: Application via Video If the nominator/applicant chooses to provide a video, the questions/criteria can be answered/addressed in the video and are not required to be completed below. The video must be no longer than 5 minutes. The video should be uploaded to a free video sharing site such as YouTube or Vimeo. This should be done with settings to share a video through a private link. If there are any difficulties in uploading the video please contact the team at indigenous-stem-awards@csiro.au or on 03 6232 5315. Video Link here: P95TB1#y1 Response 1. Please discuss any significant contributions the applicant has made to STEM initiatives, programs and/or research. Click here to enter text up to 550 words in size 10 font. P107TB2#y1 2. Please discuss the suitability and capacity of the applicant to act as a role model and provide inspiration to Aboriginal and Torres Strait Islander students, including examples of what the applicant has previously done as well as what they hope to do in this role. Click here to enter text up to 550 words in size 10 font. P136TB3#y1 3. Please add any other information that may be relevant to this application. (Please include links to relevant media etc) Click here to enter text up to 550 words in size 10 font. P166TB4#y1