Xcelerate High School Readiness Program Register Interest

REGISTER YOUR INTEREST
Parent Information
Name*

First NameLast Name
Email Address*
Phone Number*
Please enter a valid phone number.
Where is your child currently going to school?*

Elanora State SchoolPalm Beach State SchoolTallebudgera State SchoolCurrumbin State SchoolCurrumbin Valley State SchoolIngleside State SchoolCaningeraba State SchoolSt Augustine's Parish Primary SchoolOther
What year level is your child currently in?*
Do you give media consent for images that may include your child to be shared on social media?*

YesNo
Does your child have any allergies or dietary restrictions? (For our Food Technology workshop)
How did you hear about ESHS XCELERATE Academy?*

Social MediaFlyer in mailInformation from your Primary SchoolBanner on School FenceOther
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