Registration Form- School Engagement
Date
-
Month
-
Day
Year
Date
School cohort
Please Select
Primary school
Secondary school
Both
School Details
School Name
School Website
School Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Coordinating Teacher's Details
Position Title
Contact Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
Please Select
Phone Call
Email
SMS
Student Group Details
Please indicate the year levels that would be involved:
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Year 10
Year 11
Year 12
School Type
Please Select
Catholic
State
Lutheran
Anglican
Grammar
Independant
Other
Please indicate the number of active students:
If newly registered, please indicate the number of predicted active students:
Please list the activities, initiatives and services you currently engage in that have a social justice focus:
Please list the activities, initiatives and services that you are interested in that relate to raising social justice awareness:
Would you like to add any additional teachers/school staff contacts to receive our quarterly newsletter with free resources and initiatives? If yes, please include names and email address below--
Submit
Should be Empty: