Summer Master Class 2023 application form

1. Personal details
Name Name First Middle Last
Please provide your legal name as this information will be used for enrolment purposes.
Title
Gender
Please specify gender
Date of birth Date of birth / DD / MM YYYY
Are you Aboriginal or Torres Strait Islander?

Are you Aboriginal or Torres Strait Islander? Yes - Aboriginal Yes - Torres Strait Islander Yes - Aboriginal and Torres Strait Islander Prefer not to answer No
Country of origin (Country of birth)?
Are you a citizen of Australia?

Are you a citizen of Australia? Yes No
If yes, please upload a PDF copy of your Australian birth certificate or Australian Passport (and Australian Citizenship Papers where relevant) as proof of identity and citizenship.

Please note that we cannot accept a driver’s licence.

Attach Files

Please make sure you upload a PDF or reduced size PDF version of your document/s to ensure that files can be opened and read correctly to assist assessing your application in a timely manner.
Please provide a PDF copy of your Birth Certificate or Passport from your country of origin. If you have Permanent Resident or Humanitarian Visa status, please provide as many of the following as possible:

Passport
VISA grant notice
IMMI card
Birth Certificate

Attach Files

Please make sure you upload a PDF or reduced size PDF version of your document/s to ensure that files can be opened and read correctly to assist assessing your application in a timely manner.
Has any member of your immediate family attended university?

Has any member of your immediate family attended university? Yes No
Home address Home address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Is your home address different to your mailing address?

Is your home address different to your mailing address? Yes No
Mailing address, if different from home address Mailing address, if different from home address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Contact phone number (Mobile preferred)
Email

Confirm email address

Please ensure that you provide a personal email address NOT a school email address.

Please also add pathways-in2uni@uow.edu.au to your email account safe senders list to ensure that emails about this application will not be diverted to junk or spam folders or automatically deleted based on your junk/spam settings
2. Current / Previous Studies
I am completing High School at

Please provide full school name not an abbreviated version (e.g. The Illawarra Grammar School, not TIGS).
I am currently in Year 11 and will be completing Year 12 in 2023.

I am currently in Year 11 and will be completing Year 12 in 2023. Yes No
I am currently completing a study pattern that will make me eligible to receive an ATAR

I am currently completing a study pattern that will make me eligible to receive an ATAR Yes No
My NESA Student Number is:

IMPORTANT

Please ensure that you are entering your correct NESA Student Number as this will be used to match Summer Master Class completion and Early Admission applications to implement guaranteed interviews/conditional offers for Early Admission.

Failure to provide a correct NESA student number may lead to forfeiture of the above guarantee as UOW will be unable to undertake matching required without this information.
You can obtain your NESA student number from your school if you are unsure of this.
I am currently completing the following subjects:

You must add all subjects you are completing in Year 11, even if you do not plan to continue them in Year 12. Please provide either your Year 11 half yearly or yearly results.
Subject 1
Mark / Grade
Subject 2
Mark / Grade
Subject 3
Mark / Grade
Subject 4
Mark / Grade
Subject 5
Mark / Grade
Optional Subject 1
Mark / Grade
Optional Subject 2
Mark / Grade
Please upload your Year 11 Half Yearly Report or the Grade Verification Form:

Attach Files

Please upload a copy of your report to verify these grades. Alternatively, you may have your school complete the Grade Verification Form and upload this if a report is not available.

If your report has a summary sheet that shows all subjects/results, upload just this page rather than the full report.

Please only upload a PDF or reduced size PDF file of your document/s as other file types are not able to be opened for review.
3. HSC Summer Master Class subject preferences
I wish to apply for the following HSC Summer Master Class subjects:
Preference 1
Preference 2
Preference 3
I am interested in studying the following area/s at a university level:
I understand Summer Master Class delivery will include a compulsory on-campus Orientation Day on either 13 or 14 December 2022 (date determined by subject); and a mix of online and on-campus classes between 3-20 January 2023.

All planned on-campus activities and classes may be moved online if required due to COVID 19.

I understand Summer Master Class delivery will include a compulsory on-campus Orientation Day on either 13 or 14 December 2022 (date determined by subject); and a mix of online and on-campus classes between 3-20 January 2023.

All planned on-campus activities and classes may be moved online if required due to COVID 19. Yes No
4. Program fees and sponsored places and access

The cost of the Summer Master Class in 2023 is $480. Full or partial sponsorship is available for students who meet one or more of the equity criteria below.

Please note sponsored places are limited and as such meeting the below criteria is not a guarantee of sponsorship. All students will be advised at the time of their application outcome as to any sponsorship they are being provided.

Please indicate below all equity criteria that you meet.
I understand that there is a $480 administrative fee attached to this program, that will be payable upon receipt of an offer, unless I am granted a sponsored place in the Summer Master Class Program.

I understand that there is a $480 administrative fee attached to this program, that will be payable upon receipt of an offer, unless I am granted a sponsored place in the Summer Master Class Program. Yes
I would like to apply for a sponsored place under the basis of (select all that apply).

I would like to apply for a sponsored place under the basis of (select all that apply). I attend an In2Uni Sponsored School Identify as Aboriginal and/or Torres Strait Islander Financial Hardship* Disability* Diagnosed Medical Condition* (physical or mental health condition) Refugee Status* Other* (such as situational or social disadvantage)

*You will be asked to upload evidence below. Please refer to the Summer Master Class website for details of evidence required for each category.
Upload supporting documentation in PDF. (See also: Evidence requirement)

Attach Files

For information on evidence requirements, visit the Year 12 HSC Summer Master Classes page.

Please only upload a PDF or reduced size PDF file of your document(s) as other file types are not able to be opened for review.
There are a limited number of sponsored places. If you weren’t successful in receiving a sponsored place, would you be prepared to pay a $480.00 administration fee?

There are a limited number of sponsored places. If you weren’t successful in receiving a sponsored place, would you be prepared to pay a $480.00 administration fee? Yes No
Do you have access to a computer device with a web cam (laptop, tablet, desktop) from home?

Do you have access to a computer device with a web cam (laptop, tablet, desktop) from home? Yes No
Do you have access to reliable Internet connection from home?

Do you have access to reliable Internet connection from home? Yes No
5. Equity Grants
I would like to apply for one of the up to $500 financial grants available to off-set the cost associated with attending the Summer Master Classes.

To be eligible for this grant, students must also be eligible to be considered for a full or partial sponsored place in the program.

I would like to apply for one of the up to $500 financial grants available to off-set the cost associated with attending the Summer Master Classes.

To be eligible for this grant, students must also be eligible to be considered for a full or partial sponsored place in the program. Yes No

Note: Please refer to the Summer Master Class website for additional information about Equity Grants.
Equity Grant applications

To apply for this grant please attach a one page statement to this application. Please provide your statement in Arial or Times New Roman font, double spaced 12 point font. Your statement should incorporate the following:

1. Any community engagement and employment you currently undertake, including how many hours per week.
2. How this grant will assist you in overcoming any impediments to being able to undertake the Summer Master Class.
3. How the Summer Master Class program will assist you with your future study and career goals.
Upload your statement

Attach Files
6. Parent/guardian information & consent
Name of parent/guardian Name of parent/guardian First Last
Phone number of parent/guardian
Email address of parent/guardian
I (the parent/guardian) have read, and agree to adhere to, the Terms and Conditions for the Summer Master Class program as outlined on the website

I (the parent/guardian) have read, and agree to adhere to, the Terms and Conditions for the Summer Master Class program as outlined on the website Yes
I would like to receive information about the In2Uni program and HSC Summer Master Class program

I would like to receive information about the In2Uni program and HSC Summer Master Class program Yes No
7. Medical and emergency contact information
The parent/guardian listed above is my emergency contact?

The parent/guardian listed above is my emergency contact? Yes No
Emergency contact's name Emergency contact's name First Last
Emergency contact's phone number:
Relationship to student:
Do you have any medical conditions, learning needs or other additional needs?
Note: failure to disclose conditions or needs will prevent UOW from being able prepare to provide support to students for these conditions/needs.

Do you have any medical conditions, learning needs or other additional needs?
Note: failure to disclose conditions or needs will prevent UOW from being able prepare to provide support to students for these conditions/needs. Yes No
If yes, please specify:
Please upload your school based personal medical or learning support plan to assist our team to put in place any medical or learning support you may require for the Summer Master Classes.

Attach Files

Please make sure you upload a PDF or reduced size PDF version of your document/s to ensure that files can be opened and read correctly to assist assessing your application in a timely manner.
If you require any additional assistance during the program that is not outlined in your attached medical/support plan, please outline this below.

If you require any additional assistance during the program that is not outlined in your attached medical/support plan, please outline this below. Yes No
If yes, please specify:
I authorise the above parent/guardian to receive information pertaining to my application, billing status and enrolment, and to make enquiries on my behalf

I authorise the above parent/guardian to receive information pertaining to my application, billing status and enrolment, and to make enquiries on my behalf Yes No
I authorise my school to receive information pertaining to my application, enrolment, and to make enquiries on my behalf

I authorise my school to receive information pertaining to my application, enrolment, and to make enquiries on my behalf Yes No
I (the student) give my consent for the Outreach & Pathways unit to use any images or videos of my appearance in any publications, websites or publicity material

I (the student) give my consent for the Outreach & Pathways unit to use any images or videos of my appearance in any publications, websites or publicity material Yes No
I (the student) have read, and agree to adhere to, the Terms and Conditions for the Year 12 Summer Master Class program as outlined on the Outreach & Pathways website

I (the student) have read, and agree to adhere to, the Terms and Conditions for the Year 12 Summer Master Class program as outlined on the Outreach & Pathways website Yes
Privacy Disclaimer

By submitting this application form, you are consenting to UOW collecting your information and contacting you regarding the 2023 Summer Master Class Program.

The information you provide will be used by the Outreach & Pathways team to evaluate your application and improve our services and activities. Please note that UOW will not be able to determine you or your child's eligibility for the program unless you provide us with this information. If you do not wish to take part in the program you can email pathways-in2uni@uow.edu.au. to opt out at any time.

How UOW handles your personal information.

Summer Master Class 2023 application form

Summer Master Class 2023 application form

1. Personal details

2. Current / Previous Studies

I am currently completing the following subjects:

3. HSC Summer Master Class subject preferences

I wish to apply for the following HSC Summer Master Class subjects:

4. Program fees and sponsored places and access

5. Equity Grants

Equity Grant applications

6. Parent/guardian information & consent

7. Medical and emergency contact information

Privacy Disclaimer