IYI Conference Registration – Student Section STUDENT APPLICANT INFORMATION Applicant name: Email Address: Mailing Address: Best phone to reach you: Date of Birth (mm/dd/yyyy): Name of High School: Do you self-identify as an Indigenous person? YesNo What grade level are you currently completing? Level 1 (Grade 10)Level 2 (Grade 11)Level 3 (Grade 12) Personal Statement In order to help WISE NL understand why YOU are interested in the conference and careers in Science and Engineering, please tell us something about yourself. We are especially interested in your interests, possible post-secondary plans, and school or community activities in which you are involved. Feel free to include any other information that you think may be useful. VERIFICATION I affirm that I am the person submitting this application. YesNo Name: Today's date: Please remember that your application is not considered complete until your Parent/Guardian permission form has also been received. What's Next? After clicking on the "Submit" button, this information will be sent to the IYI organizers and a copy emailed to you. The information is not retained on our website. Once the email is received by the IYI organizers, the information is considered confidential. If you wish to change any information, follow the instructions in the acknowledgement email.