STEM Academy Year 12 Program Student Registration

First Name *

Last Name *

Date of Birth *

Please use format MM/DD/YYYY

Personal Email Address *

Please don't use your school email address.

I would like to receive email communications from the ��Vlog of Adelaide relevant to me. *

Mobile Phone *

I'm happy to receive SMS communication from the ��Vlog of Adelaide.

Citizenship Status *

Do you identify as Aboriginal or Torres Strait Islander? *

High School *

What year level are you in 2024? *

What STEM degree are you most interested in studying at ��Vlog? *

Please note that this information is used by us to help support your decision-making process and will not affect your early conditional offer.

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