Learning Labs 2021 application form - Southern Highlands

Thank you for your interest in applying to Learning Labs. Please be aware that all workshops will operate in accordance with COVID safe guidelines as required by State and Federal authorities. These are constantly changing and we will inform you of any updates to our operating procedures as these changes occur. We are a COVID-Safe program and adhere to strict social distancing and hygiene measures throughout the program.

I am applying for:

I am applying for: Early Learning Labs (Years 3-4) Early Learning Labs (Years 5-6)
Have you applied to attend this program before?

Have you applied to attend this program before? Yes, I have attended a Learning Labs program before. Yes, I have applied to attend but was not placed or had to withdraw due to COVID reasons in April 2021 or July 2021. No, I have never applied before.
Student Name Student Name First Last
Street address
Address line 2
Suburb
State
Postal code
Maximum of 4 digits allowed. Currently Entered: 0 digits.
Student email (if applicable)
School

Click on the drop down and start typing the name of your school
If school not on list
School Year/Grade (2021)
Date of birth Date of birth / DD / MM YYYY
Gender

Gender Male Female Prefer not to disclose Other Other
Are you of Aboriginal and/or Torres Strait Islander descent?

Are you of Aboriginal and/or Torres Strait Islander descent? Yes No
Is there a sibling applying to this program?

Is there a sibling applying to this program? Yes
Must all siblings be placed to attend this program?

Must all siblings be placed to attend this program? Yes No
Parent/Guardian name Parent/Guardian name First Last
Contact number (no spaces between numbers)

It is crucial that this phone number is working and accessible during the program, in case of emergencies.
Email
Medication/Special Requirements

Please email learning-labs@uow.edu.au or attach any medical plans related to your child’s medical condition. If your child is anaphylactic, asthmatic or diabetic, up to date medical plans are required prior to attendance. This is required each time you apply. Students are also required to bring their medication each day they attend.
Please attach Medical Plan (if applicable)

Attach Files

Max File Size: 5MB
Behaviour Support Needs

If your child has behaviour support needs and/or an Individual Learning Plan (ILP), please give details here and attach any supporting documents that will assist us in providing the best learning experience for your child.

This information will not impact on your child's placement, it will give us a greater understanding of you child's needs & any modifications that need to be made.
Please attach Individual Learning Plan (if applicable)

Attach Files

Max File Size: 5MB
Workshop preferences:

Please select up to 4 workshop choices in order of preference.
If available, I am interested in attending BOTH the 2 day and 1 day Mini Program (see our FAQs)

If available, I am interested in attending BOTH the 2 day and 1 day Mini Program (see our FAQs) Yes

You can attend both the 2 and 1 day program if there is space.

Ticking this box does not guarantee placement in 2 AND 1 day workshops. It is dependent on the amount of applications and popularity of the workshop. We try to place a student in at least one workshop.
Workshop description

Southern Highlands Workshop Description Years 3 - 6 (PDF)
** Only select workshops that you are interested in and are willing to attend.**

You do not need to fill out all 4 preferences if you are only interested in 1 or 2 workshops.
First Preference (Years 1 - 2)
Second preference (Year 1 - 2)
Third preference (Years 1 - 2)
Fourth preference (Years 1 - 2)
First preference (Years 3 - 4)
Second preference (Years 3 - 4)
Third preference (Years 3 - 4)
Fourth preference (Years 3 - 4)
First preference (Years 5 - 6)
Second preference (Years 5 - 6)
Third preference (Years 5 - 6)
Fourth preference (Years 5 - 6)
First preference (Years 7 - 10)
Second preference (Years 7 - 10)
Third preference (Years 7 - 10)
Fourth preference (Years 7 - 10)
In your own words, please tell us why you would like to attend these workshops.

It is OK for parents to translate for the little ones!
What do you hope to get out of the workshop? Tick all that apply.

What do you hope to get out of the workshop? Tick all that apply. Learn more about the subject area Learn more about the careers that come from the subject area Meet people who like the same subject as me Experience spending time at the university campus Do something different in the school holidays

It's okay if parents translate for the little ones!
Cost

Early Learning Labs: $95.
Do you intend on using a Creative Kids (CK) Voucher if a CK-eligible place at Learning Labs is provided to your child?

Do you intend on using a Creative Kids (CK) Voucher if a CK-eligible place at Learning Labs is provided to your child? Yes No
Voucher Number (enter the 12 digits after 9999 without spaces)
Must be 12 characters. Currently Entered: 0 characters.
Please enter the 12 digits after 9999 without spaces.
Upload your voucher here:

Attach Files

Max File Size: 8MB. If you are unable to upload your documents, please email them to in2uni@uow.edu.au
Please note:

Please refer to the Workshop Descriptions for all workshops eligible to use a Creative Kids Voucher. If a place is not allocated to your child in one of these workshops the voucher will not be used by Learning Labs and remains the property of the parent.
Sponsorship

Alternatively, you can apply for a sponsored placement if you meet one of the criteria below.

We have limited sponsorship places available. If we are unable to provide a sponsorship, you will be offered a fee place position.
Please indicate if you wish to apply for a sponsored place:

Please indicate if you wish to apply for a sponsored place: Yes, I am applying for a sponsored place and meet one or more of the criteria below.
• I am experiencing financial disadvantage
• I am experiencing social disadvantage
• I am an Australian Aboriginal or Torres Strait Islander

Please note: attending an In2Uni school is NOT the sole criteria for sponsorship. You need to fulfil one of the above points and explain your circumstances below.
Please explain your circumstances:
Supporting documents (for first time applications to the program only)
Please upload any supporting documents with your application. (You do not need to supply if you are a past program participant.)

Attach Files

Max File Size: 8MB

If you are unable to upload your documents, please email them to in2uni@uow.edu.au
Please indicate which qualifying information you have attached to your application form (you only need ONE from the following list):

Please indicate which qualifying information you have attached to your application form (you only need ONE from the following list): Teacher nomination letter Distinction or High Distinction in the Australian Schools Science, Math or English Competitions An academic scholarship of some description Placement or offer of placement in a self contained class for academically gifted students (Selective School , OC Class or pull out program) A score within the top band of the relevant aspect in the NAPLAN test (literacy or numeracy) 90th percentile or above on any individual or group IQ test For Little Learning Labs only: Parent nomination letter
Participation in Learning Labs
I understand that prior to my child's attendance of Learning Labs if any household member, including the attending child, show COVID like symptoms we are not permitted to attend Learning Labs and a full refund will be provided.

I understand that prior to my child's attendance of Learning Labs if any household member, including the attending child, show COVID like symptoms we are not permitted to attend Learning Labs and a full refund will be provided. Yes
I have read, agree and adhere to the Terms and Conditions for the Learning Labs program as outlined on the In2Uni website.

I have read, agree and adhere to the Terms and Conditions for the Learning Labs program as outlined on the In2Uni website. Yes
I understand that in the 14 days leading up to my children's attendance of Learning Labs that should any household member come into contact with positive cases, or have visited known hotspots, we are not permitted to attend Learning Labs and a full refund will be provided.

I understand that in the 14 days leading up to my children's attendance of Learning Labs that should any household member come into contact with positive cases, or have visited known hotspots, we are not permitted to attend Learning Labs and a full refund will be provided. Yes
I hereby consent for the University of Wollongong to release my child’s name and workshop information to their school post attending Learning Labs.

I hereby consent for the University of Wollongong to release my child’s name and workshop information to their school post attending Learning Labs. Yes No
I give my consent for In2Uni/Learning Labs to use any images or videos of my appearance in any publications, websites or publicity material.

I give my consent for In2Uni/Learning Labs to use any images or videos of my appearance in any publications, websites or publicity material. Yes No
I understand that students will have to organise their own transport arrangements to and from the campus.

I understand that students will have to organise their own transport arrangements to and from the campus. Yes No
With parent/guardian permission, students age 12 and above may walk or take public transport. If you would like to authorise your child to leave the programs without a responsible adult, please indicate.

With parent/guardian permission, students age 12 and above may walk or take public transport. If you would like to authorise your child to leave the programs without a responsible adult, please indicate. Yes, they may leave the campus after their workshop No, they must wait for an adult to pick them up
UOW staff have the authority to treat or seek treatment for my child in the case of a medical emergency.

UOW staff have the authority to treat or seek treatment for my child in the case of a medical emergency. Yes No
Submission

Your application details will be processed by UOW staff. Please ensure all information provided is correct before submitting.

Please make sure to click the 'submit' button on the review pages.

You will be notified via EMAIL regarding the success of the application. This will happen by Friday 20 August 2021.

Successful applicants will be sent information regarding payment at this time. Payment must be received to confirm your place in the program.

For families who have limited access to a scanner or are having trouble filling out this form, please print and post in your application with a copy of your supporting documents to:

Sarah Smith
Learning Labs
Bldg 17, Lvl 2
University of Wollongong NSW 2522
Privacy statement

The information provided to UOW Outreach & Pathways will help us to inform the content and development of our programs. De-identified, aggregated data may also be used for reporting purposes and quality assurance activities. Further information about how UOW handles your personal information can be found at www.uow.edu.au/privacy.

Learning Labs 2021 application form - Southern Highlands

Learning Labs 2021 application form - Southern Highlands

Workshop preferences:

Workshop description

Cost

Please note:

Sponsorship

Supporting documents (for first time applications to the program only)

Participation in Learning Labs

Submission

Privacy statement