1998 BHP Science Student Awards Entry Form · Name of Project: Project title for certificate ......

BHP Billiton Science and Engineering Awards 2018 Student Entry Form

PLEASE COMPLETE ALL SECTIONS OF THIS FORM FOR A VALID ENTRY Project Information

Name of Project:

Project title for certificate (max 80 characters inc spaces):

Starting date of research:

What category are you entering? Investigations Engineering

Is this a joint entry? Yes No (Please submit a separate entry form for each of the other joint entrants)

Name of your partner(s) in this entry:

Have you previously entered a project on this or a similar topic into the BHP Billiton Science and Engineering Awards? Yes No

(If yes, please attach a note stating clearly how the current entry differs significantly from the previous entry.)

Name of other competitions project entered into (if applicable):

Student/Parent Information (Please ensure this is completed, applicable certificates and cheques will be sent to this address)

Surname: Given Name:

Street Address:

Suburb: State: Post Code:

Home Telephone: Email:

Male Female Other Date of Birth: Age: Student Mobile:

Australian citizen Permanent Resident Other Specify:

Name of Parent/Guardian: Parent/Guardian Email:

Parent/Guardian Home Telephone: Parent/Guardian Mobile:

School Information School Name:

School Address:

School Telephone: School Fax: Year Level:

Is this a Primary or Secondary entry?

School STA Competition Coordinator:

Supervising Teacher/Project Supervisor to complete: I, declare that

this project is the work of my student (s)

Supervising Teacher’s Signature: Date:

Declaration of Originality I, declare this project is all my/our own work and I/we have acknowledged in my/our

report the assistance I/we have received from others.

(BHP Billiton Science and Engineering Awards finalists will be required to provide complete details of any outside assistance on a pro-forma once they are selected – Projects with incomplete or inaccurate forms will not be eligible to be judged. The level of assistance will be a factor in judging and may influence up to 10% of the final score.)

Signed: Date: