Registration form

Welcome to Connecting the dots: knowledge brokering for impact and innovation registration form. 

Please use this form to secure your place in the the online events on February and March. You can also use this form to request an accessibility grant to support your attendance to the event. 

 

If you have any questions, please contact us at emcr@science.org.au 

Privacy Notice and Data Processing Consent

* By participating in the Symposium, you acknowledge, understand and consent to the collection, use and disclosure of your personal information (including your sensitive information) in accordance with the Symposium Privacy Notice. 

option required

Contact Details

If you feel comfortable sharing, can you let us know if you identify as any of the following?

Current field(s) of work or research

Select all that apply. Based on FoR Research Classifications – STEM topics only

Do you require carer or accessibility support to facilitate your attendance to the event?

Support grants are available to attendees to ensure equal participation at the event, let us know your needs and we will try our best to support you. E.g., additional day of childcare, Auslan interpreter, closed captions, assistance with internet connectivity, headsets, etc.

Do you consent to your details being added to a participant list to be shared with other participants and speakers?

Experience and expectations

Please use this section to let us know a bit more about you, your experience and expectations. This information will help us make sure the content of the sessions is relevant to our participants

Have you engaged in knowledge brokering before?

If yes, what is your level of knowledge brokering experience?

What is your goal for attending this symposium?

Select all that apply

If you selected 'other', please enter your answer below.

What domains are you interested in performing knowledge brokering in?

If you selected 'other', please enter your answer below.

What knowledge brokering contexts are you interested in?

Select all that apply, they can be areas you currently work or would like to work .

If you selected 'other', please enter your answer below.

Summary

Participants must abide by the Australian Academy of Science's participant code of conduct.

Please confirm the information included above is correct.

Thank you for your registration, we look forward to seeing you at the event. More information about the program will be available on the event website shortly. An e-mail with further information including meeting links will be sent to participants in early February.

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