Widening Participation - Outreach and Learner Engagement - School/ Community Organisation

I am booking on behalf of a

School

Organisation

School/ Community organisation name

Main Contact

Name

First Name

Last Name

Position

Direct Contact Details

Email
Phone	Mobile

Alternative Contact (Optional)

Name

First Name

Last Name

Position

Alternative Contact Details

Email
Phone	Mobile

Visit Details

Please specify your other Year level/Cohort

Activity

Class Subject

Please give a brief description of the project/activity your students will be undertaking

Session Format

QUT Student Ambassador mentors to accompany data collection excursion

QUT Student Ambassador mentors to provide data analysis mentorship

Both excursion and post-excursion mentorship

Half day workshop

Full day workshop

One off session

Ongoing mentoring (i.e. weekly)

Excursion date

1st preference

Date of Activity

Please nominate time of day

Post-Excusion mentorship date

2nd Preference

Date of Activity

Please nominate time of day

How many classes do you require?

We can run up to 4 rotations of classes per day. More than four classes will require multiple visit dates.

Year 10 Explore Careers Day

This event is held on one day only in late May. The exact event date will be provided in the confirmation email.

Year 11 and 12 Explore Careers Day

This event is held on one day only in late July. The exact event date will be provided in the confirmation email.

Number of Students/Participants

Please describe the type of engagement you are requesting

Please describe the time and duration requirements of your request

Comments

Please provide details