LIZARD ISLAND STUDY TOUR 2020APPLICATION FORM - STUDENTApplicant detailsFirst name Click or tap here to enter

text.Last name Click or tap here to enter text.

Date of birth Click or tap to enter a date. Female ☐ Male ☐ Other ☐Home phone Click or tap here to enter

text.Email Click or tap here to enter text.

Home address Click or tap here to enter text.Parent/Guardian contact detailsName Click or tap here to enter text. Relationship Click or tap here to enter text.Mobile Phone Click or tap here to enter text. Email address Click or tap here to enter text.Parent/Guardian should complete below as applicable.Sydney based applicants☐ We live in Sydney or surrounds and can arrange suitable transport for the applicant between home and Sydney Airport at both ends of the trip.☐ We live in Sydney and may be able to provide overnight accommodation at our home and transport to/from the airport for other student participants at one or both ends of the trip.

Non-Sydney based applicants☐ We do not live in Sydney but we are able to arrange suitable accommodation and transport arrangements for the applicant when in Sydney. ☐ We do not live in Sydney and would like help from other participants’ families with accommodation and transport arrangements in Sydney.

School detailsSchool name Click or tap here to enter text.2020 year level

Click or tap here to enter text.

Science subjects chosen for 2020

Click or tap here to enter text.

School contact name

Click or tap here to enter text. Position Click or tap here to enter text.

Phone number Click or tap here to enter text.

Email Click or tap here to enter text.

Applicant Checklist (Please include the following information with your application form.)1. Personal submission (tell us why you want to come on the trip, how it will benefit your

studies, your future career and the world). Please indicate if you have: ☐ Submitted as a video via Vimeo Please include Vimeo link here: Click or tap here to enter text. ☐ Submitted as a video via the mail ☐ Submitted as a written piece

2. Letter of support from the school signed by your Science teacher and the Principal.3. Letter from the school (or swimming coach) verifying your swimming ability. 4. Letter from your parent(s) and/or guardian(s) confirming your ability to travel with minimal

supervision, to swim and snorkel from a boat, and to behave responsibly away from home

while contributing to group work (scientific and household)