Expression of Interest - Education and Outreach Program


School Name * :
School Address * :
Suburb * :
State * :
Postcode * :
School Phone (Please include area code) :
Contact details
Name of best contact person * :
Position * :
Email * :
Phone * :
Principal details (if different from above)
Principal Name :
Principal Email :
Workshop details
Preferred dates * :
Number of different classes to participate (Up to 8 - max 30 students per class). Please indicate grade/age. * :
Number of available spaces to run workshops * :
Description of spaces for workshops * :
School bell times
Start of day * :
Recess (start & finish) * :
Lunch (start & finish) * :
End of day * :
Please select your preferred performance * :
Is there anything else you would like us to know about your school or students :