UNSW Indigenous Science & Engineering Program 2018

Transcription

1 Personal Details Forms The following forms must be completed by the parent or guardian of the Indigenous Science and Engineering Program participant and returned to Nura Gili by 5.00pm FRIDAY 6 th NOVEMBER. PARTICIPANT S FULL NAME: *See Note Below DOB: - - GENDER: Female / Male / Other Medical Requirements: Allergies: Dietary Requirements: Religious/Cultural Requirements: (NOTE: Additional information on requirements listed above should be attached on a separate page) Medicare #: Health Care Card #: Family/Local Doctor Name: PLEASE STICK PORTRAIT PHOTOGRAPH HERE Family/Local Doctor Address: Family/Local Doctor Phone Number including area code: PARENT/GUARDIAN DETAILS Name: Home Number: ( ) Relationship to Participant: Work Number: ( ) Mobile Number: ALTERNATIVE EMERGENCY CONTACT Name: Home Number: ( ) Relationship to Participant: Work Number: ( ) Mobile Number:

2 Attendance Declaration This is to confirm that is accepting their invitation to attend the UNSW Indigenous Science and Engineering Program from Wednesday 28 November to Friday 30 November I give permission for my son/daughter (participant s name) To attend the 2018 UNSW Indigenous Science and Engineering Program To attend any excursions that may be included in the program Parent/Guardian / / Parent/Guardian Name Signature Date

3 Travel Details All participants are required to make their own way to and from UNSW for the program. Arrival: Wednesday 28 November 2018 All participants need to arrive at UNSW by 8.00am. Registration will take place at New College. The address for New College is 330 Anzac Parade Kensington. Anzac Parade is a main road therefore, for safety reasons we ask that you be dropped off on the UNSW grounds via Gate 14, Barker Street. Upon entry to Gate 14, turn left and follow this road all the way to the end, past Shalom College on your left and the Village Green on your right. At the end of the road, turn right and New College is about 10 metres ahead. There will be signs and balloons directing you where to go. NB: If you are caught in traffic and/or running late, please contact Summa Naylor on the numbers provided in the back of the booklet. Departure: Friday 30 November 2018 All participants can be picked up from 4:30pm at New College. Participants must be collected by 5.30pm. Please sign below that you understand that it is your responsibility to arrange travel for your child to and from the program. Parent/Guardian / / Parent/Guardian Name Signature Date

4 Behaviour Declaration In the best interests of all those participating in the UNSW Indigenous Science and Engineering Program (ISEP) and to ensure a smooth and harmonious program is enjoyed by all, the following ISEP Principles and Values guidelines have been developed. All students attending ISEP should read the guidelines thoroughly and agree to the behavioural declaration by signing below. Parents and guardians are also required to read and sign the declaration below. If you have any questions in relation to the program including this declaration, please contact Nura Gili Indigenous Programs at UNSW on (02) ISEP Principles and Values UNSW staff and students strive to create a learning and teaching environment that provides participants, staff and facilitators an outstanding, safe and enjoyable experience during the ISEP program. To achieve this, we ask all students and parents to be mindful of the following principles: All persons engaged in the ISEP program as well as all property and equipment both on UNSW campus and at organisations we visit, are to be treated with care and respect. Un-prescribed drugs, cigarettes and alcohol are not permitted on UNSW premises and at organisations we visit. Students engaging in inappropriate behaviour that is disruptive, disrespectful and inappropriate will be counselled by supervisors and ISEP staff. Incidents involving inappropriate behaviour should immediately be reported to a supervisor or ISEP staff member. Students are accountable to their supervisors and ISEP staff at all times and are not permitted to leave the ISEP group unaccompanied for the duration of the program. Using polite and respectful language and communication towards fellow students, supervisors, ISEP staff and facilitators is highly recommended. Students are required to comply with all requests from supervisors and ISEP staff to switch off mobile phones during certain activities and excursions. Students are to be mindful that they are representatives of their schools and communities and therefore, their behaviour during ISEP should reflect this. Should students become uncomfortable or unwell, they are encouraged to seek support and assistance at any time of the day or night from a supervisor or ISEP staff member. ISEP participant wellbeing is a priority for UNSW and we encourage all students to engage with each other, supervisors, ISEP staff and facilitators in a healthy and harmonious way. Please note that significant breaches of the above principles and values may result in suspension from ISEP. All supervisors employed by UNSW have undertaken the Working with Children Check and have completed training relevant to their role in the program.

5 Nura Gili, ISEP Coordinators and Supervisors highly value professionalism, respectfulness and behavioural excellence from each other and from our participating students. We look forward to connecting with each and every student to deliver a memorable journey of discovery experience during ISEP By signing the declaration below, students and Parents/Guardians accept the principles and values set out above and fully understand the consequences for students in breach of these guidelines. I have read and understand the Behaviour Declaration and the ISEP Principles and Values of the UNSW Indigenous Science and. Participant / / Participants Name Signature Date Parent/Guardian / / Parent/Guardian Name Signature Date

6 Media Release Form Dear Participant/Parent or Guardian, To be able to use your/your child s photograph, image, words, artwork or video/audio recording (the talent ) we need your permission. Wherever possible, UNSW Sydney will be understanding of cultural, family and personal sensitivities. If you do not wish your/your child s photograph, image, words, artwork or video/audio recording to be used or are under the age of 18, please let us know now. By signing this form you have granted UNSW Sydney and its representatives, employees, agents and assigns, the irrevocable and unrestricted right to use, reproduce and publish: The photographs taken of you/your child, including your/their image and likeness as depicted therein; The statement of testimonial made by you/your child either via video/audio or word; The artwork made by you/your child; For editorial, trade, advertising or any other purpose including social media and in any manner and medium, to alter without restriction. Please indicate and sign below if you give permission for you/your child s photograph, image, words, artwork or video/audio recording to be used for the purposes stated above or if you do not wish for your/your child s images to be used. Please indicate below: YES, I give permission NO, I do not give permission Print Name Signature Date Parent or Guardian permission required if under 18 years of age Print Name Signature Date

7 Final Checklist Check the boxes to confirm that you are returning all forms as we are unable to accept partial, incomplete or late applications. If you require further information, please contact Nura Gili on (02) Final Checklist N o I have completed all sections of the Personal Details Form, including emergency contacts, any special dietary or medical requirements and I have attached a photograph as requested. N o I have signed the Attendance Declaration, confirming my child s participation in the program. N o I fully understand the Travel Details and the responsibilities of both Nura Gili and the participant and their family in ensuring safe passage to and from the program. N o I have read and agree to the Behaviour Declaration and understand the rules and regulations of the program. N o I have read and signed off on the Media Permission slip in relation to the program. Student Signature: Parent/Guardian s Signature: Date: Date: Forms Checklist p p p p Personal Details Form Attendance Declaration/Travel Details Form Behavioural Declaration Media Permission *Please note: parking is limited around the UNSW campus and there is no free parking anywhere on the grounds. However, paid parking is available on the upper level of the UNSW car parks located off Botany St and Barker St.

8 RETURNING YOUR FORMS Preferred method Please submit your completed forms by having someone scan and your completed documents to Alternatively, you can submit your documentation in the following ways: Questions or enquiries: (02) NOTE: To confirm your place in the program, please ensure documents are scanned and ed by no later than Tuesday 6 th NOVEMBER 2018