Application for information package - Women Into Science & Technology

Congratulations on your decision to return to study! We look forward to having you enrolled in WIST!

Personal Details

* Given names

* Surname

* Date of birth

* Are you an Australian Citizen? Yes No

* Residential address

* Postal address

(If the same as residential address write "As above")

Phone:* Please provide at least one phone number

Home phone
Work phone
Mobile phone

E-mail address

* Have you been previously enrolled at CQU? Yes No
Student Number (if known)

* I am able to access to the internet from: Home Elsewhere No access

* How did you hear about WIST?

* Have you spoken to a Program Advisor at CQU? (FSEH Program Advisors)
Yes No

* In which year do you expect to apply for University?

* What undergraduate degree program/s do you expect to apply for after you successfully complete WIST?

If you need help to choose an undergraduate program, you can access the CQU handbook online at http://handbook.cqu.edu.au/

* At which University?

Faculty of Sciences, Engineering & Health

Application for information package - Women Into Science & Technology