STEM Teacher Award Application Applications close midnight (AEST) on Wednesday 3 November 2021. Application Process To apply please email indigenous-stem-awards@csiro.au with the following attachments:  Application form | The applicant or nominator must complete: o Personal information o Privacy statement, o Eligibility information, o Selection criteria and supporting evidence can be provided in written format or by video response to a maximum of four minutes  Referee form(s) | Referee(s) 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 or PDF.  Profile photo | To be used publicly if selected as a winner. Ideally the photograph should be a close-up portrait from the waist up, in good light and with a simple background. Here are 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 Teacher award, the applicant must be able to answer ‘yes’ to the following questions: yes no Has the applicant contributed to the effective and innovative implementation of Indigenous knowledge into core STEM programs and Teacher Professional Development? Has the applicant engaged locally with Aboriginal and Torres Strait Islander leaders, community, and organisations? 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) 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: Email: Contact Phone: Town: State: Postcode: Traditional Place name/Country on which you live (if known): School Name: Principal’s Name: ____________ School Phone: ________________________ School Email: __ 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: • be implementing STEM-related program(s) that engage Aboriginal and Torres Strait Islander students and be able to demonstrate the impact/s this is having on Aboriginal and Torres Strait Islander students as well as non-Indigenous students. • have participated in and contributed to Teacher Professional Development that incorporates Indigenous knowledge into core STEM programs and lesson plans that align with Australian curriculum. • be engaging locally with Aboriginal and Torres Strait Islander leaders, community and organisations to incorporate Indigenous knowledge into core STEM programs and lesson plans. 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 4 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: P84TB1#y1 Response 1. Please describe how the applicant has implemented STEM-related program(s) that engage Aboriginal and Torres Strait Islander students and demonstrate the impact/s this is having on Aboriginal and Torres Strait Islander students as well as non-Indigenous students Click here to enter text up to 550 words in size 10 font. P95TB2#y1 2. Please tell us how the applicant has participated in and contributed to Teacher Professional Development that incorporates Indigenous knowledge into core STEM programs and lesson plans that align with Australian curriculum Click here to enter text up to 550 words in size 10 font. P124TB3#y1 3. Please tell us how the applicant has contributed to engaging with Aboriginal and Torres Strait Islander leaders, community, and organisations to incorporate Indigenous knowledge into core STEM programs and lesson plans. Click here to enter text up to 550 words in size 10 font. P153TB4#y1 4. (Optional) 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. P183TB5#y1