Penrith Regional Gallery - Schools Booking Form

Teacher's Details
These will be used to send all essential communications.
Name*

TitleFirst NameLast Name
Position*
Work Phone*

Area CodePhone Number
Mobile Phone

Area CodePhone Number
Email*
example@example.com
Additional Teacher's Details
If another teacher is attending on the day, please provide their details so we can communicate essential and up to date information to them prior to the event. If not, please leave this section blank.
Name

TitleFirst NameLast Name
Position
Mobile Phone

Area CodePhone Number
Email
example@example.com
Admin/Accounts Team's Details
These will be used for invoice management purposes.
Name*

TitleFirst NameLast Name
Work Phone*

Area CodePhone Number
Email*
example@example.com

Year Group/s of Student's Attending*
Reasons fo visiting Penrith Regional Gallery*
Relevant focus or content areas students are studying*
This school is a:*

Department of Education SchoolCatholic Systemic SchoolIndependent SchoolSpecific Needs SchoolHome SchoolPreschool/ Early Learning Centre

Step 3: Event Details
Select the Excursion Types:

Self-Guided Exhibition Visit (Free)Guided Exhibition Tour ($10 per student)Guided Exhibition Tour and Workshop ($15 per student)Garden Sculptures Tour and Workshop ($15 per student)Collection Up Close ($10 per student)Drawing in the Garden ($15 per student)Professional Development for teachers
Exhibition/Event Name*
Date (First Preference)*

DayMonthYear
Date
Time (First Preference)*

:HourMinutesAM/PM Option
Date (Second Preference)*

DayMonthYear
Date
Time (Second Preference)*

:HourMinutesAM/PM Option
Number of Students Attending*
Number of Teachers Attending (Including extra support staff and parents)*
At Penrith Regional Gallery, we are dedicated to creating inclusive arts experiences. If there are any additional requirements you have for your group, please let us know and we will do our best to accommodate your request.
Do you consent to the Gallery documenting your visit for archival purposes and use on our website and social media platforms?*

YesNo

Step 5: Help Us Reach You

We would like to find out the best way to communicate with you about future events.
How did you find out about this performance/event?*

Penrith Regional Gallery's WebsitePP&VA's Arts Education BrochureFacebookInstagramWord of MouthOther
Have you participated in Penrith Regional Gallery's Learning Programs in the past?

YesNo

Step 6: Additional Comments and Agreement
Please let us know of any other comments or information in regards to your booking, below.
Agreement*

I confirm that the information provided on this form is true and correct
Today's Date*

DayMonthYear
Date
Please verify that you are human*
Should be Empty:

Step 1: School Contact Details