CAGIS Seismic Impact Award Application – Canadian Association for Girls In Science (CAGIS)

The CAGIS Seismic Impact Award recognizes girls, nonbinary, and gender nonconforming youth who have made a difference in their communities with their efforts to make science, technology, trades, engineering, or mathematics (STEM) more equitable, diverse, inclusive, or accessible for underrepresented groups in STEM.

Eligibility: Girls, nonbinary, and gender nonconforming youth residing in Canada; aged 7-17 as of September 24, 2022

Deadline to apply: August 8, 2022 at 11:59 Pacific Time

Award Application *

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CAGIS Seismic Impact Award Application

First Name *

Last Name *

Age *

Email *

Parent/Guardian's First Name *

Parent/Guardian's Last Name *

Parent/Guardian's Email *

Tell us about your efforts to make science, technology, trades, engineering, or mathematics (STEM) more equitable, diverse, inclusive, or accessible for underrepresented groups in STEM. Within your answer, please tell us about your efforts, why you decided to do this work, and how you did the work. (200 words or less)

CAGIS Seismic Impact Award - Your Efforts *

Please tell us about the current or possible future reach of your efforts (i.e. does it or could it impact people?). (100 words or less)

CAGIS Seismic Impact Award - Your Impact *

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Yes No

By selecting yes, I, the applicant, certify that the information provided on this application form is true and accurate. I authorize my name, photograph, application content, and information pertaining to the CAGIS Youth STEM Awards to be publicized and posted online and in print.

Applicant Declaration *

Yes No

I certify that I am the parent/guardian of the named applicant. By selecting yes, I am giving consent for my child to participate in the CAGIS Youth STEM Awards. I also authorize that my child's name, photograph, application content, and information pertaining to the CAGIS Youth STEM Awards may be publicized and posted online and in print.

Parent/Guardian Declaration

Yes No

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Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

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Postal Code *