Spark Application 2015

Nomination Form
Instructions:
1. PLEASE COMPLETE THIS APPLICATION ELECTRONICALLY AND SEND ALL PARTS VIA
EMAIL

2. Complete the Nomination Form, save in the format:

STUDENTSURNAME_STUDENTFIRSTNAME_Nomination.doc.
3. Email the completed form as a .doc to:
Applications
E: studentapplications@spark.ywb.com.au

4. Check the student you are nominating has completed and submitted the two parts
of the application (the Student Form and the Application Question) to complete their
application process.

Nominators details
Name of Nominator:
Preferred contact
number:
Email address:
Relationship to
student:

Alternate contact
number:

Students details
Nominated

School:
student:
Reason for nomination: (Respond in 500 words or less.)

Spark Engineering Camp is a week-long university camp that aims to empower students in
grades 10-12 to pursue further education pathways and realise their potential.
Typically the students Spark aims to target have faced some form of barrier that might
inhibit their potential. As the nominator these barriers need to be specified, as this is what
will be used to determine which students Spark can empower to go on the Engineering
Camp.
Typically past students have come from a diverse range of demographics including but not
limited to:

Indigenous
Torres Straight
Islander

Low-socio
Economic
Special Needs

Refugee
Learning
Difficulty

Rural
Foster
Care

If you experience any difficulties in completing this form, please contact one of our
Student Coordinators directly:
Matthew Nguyen
Adalya Nash Hussein
Jameel Khan
National Students
Victoria Students
Queensland Students
Coordinator
Coordinator
Coordinator
E:
E:
E:
students@spark.ywb.com students.melb@spark.ywb.co students.bris@spark.ywb.com.
.au
m.au
au