STEM School Award 

Evidence of Engagement and Implementation 



To be eligible for this award, applicants must be able to show effective engagement with the 
local Indigenous community to effectively implement innovative STEM programs. 

•All applicants are required to submit at least one reference to support this nomination
•Submissions can include supporting letters or recordings from the local Indigenous community,
Traditional Owner(s), parents, students, and other related stakeholders to the school
































































INDIGENOUS STEM AWARDS 






Referee Privacy Statement 

Use of personal information provided by the referee 

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 and any video 
responses. 

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 consent to the collection and use of your personal information as set out in this privacy statement? 

Yes 
No 










Referee Details 



First Name: Last Name: 

Contact Phone: Email: 

School Name: 



Your relationship to school? 
















NOTE: Evidence via Video 

If providing supporting evidence via a video or sound recording, it must be no longer than 4 minutes. The 
video should be uploaded to a free video sharing site such as YouTube.com or Vimeo.com. Sound recordings 
can be uploaded to SoundCloud or a similar service. Recordings should be saved with settings to share 
through a private link. If there are any difficulties in uploading the video or sound please contact the team 
at indigenous-stem-awards@csiro.au 

Video Link here: 



P70TB2#y1


1.Please add any supporting evidence or information that may be relevant to this application.



P72TB1#y1

1.Continued



P73TB3#y1