Shoalhaven 2019 STEMship Program Step 1 of 6 16% Section BreakTo let us know you are interested in participating, please complete this form and RDA Far South Coast will contact you to provide further information. The personal information we collect will be kept in confidence by RDA Far South Coast and used to help us with developing relevant youth programs. The questions we ask about your career interests will help you and RDA Far South Coast decide which STEMship subjects and potential work/employment placements will be most suitable.Contact DetailsName* First Last Address* Postal Address Suburb State Postcode Email* Date of Birth* Date Format: MM slash DD slash YYYY Home Phone*Mobile Phone*Gender*SelectMaleFemaleRather Not SayOtherHow did you find out about the STEMship program?* Do you currently attend school?*SelectYesNo Section BreakName Of School*Contact person for school*School phone number*Current Year at School*SelectYear 10Year 11Year 12 DisabilityDisability*Disability (Please tick the boxes which apply to you) None Vision Hearing/Deaf Physical Medical Condition Intellectual Mental Illness Learning Acquired Brain Impairment Other Language and Cultural DiversityAre you of Aboriginal or Torres Strait Islander origin?*SelectNoYes, AboriginalYes, Torres Strait IslanderPrefer not to sayWere you born in Australia?*SelectYesNoDo you speak a language other than English at home?*SelectNoYesPlease specify language/s* OtherWhy do you want to participate in the STEMship Program 2019*Tick the area you would like to work in (check all that apply)* Aero Space Engineering Electrotechnology Information Technology Advanced Manufacturing Telecommunications Electronics Other Briefly explain what you think you will be doing in this role?*What do you think you might want to do after the course?*Tell us about your interests and achievements? (Including: educational qualifications, work/life experience, volunteering, sporting activities etc.)*Upload Supporting DocumentsFor example, Resume, Letters of Recommendation etcI understand that information contained in these forms may be provided to State and Commonwealth agencies and research organisations and I consent to that occurring. I certify that all details provided on these forms are correct.