Real Talk - Secondary School Booking Form

Secondary School Booking Form
Contact Information
Full Name

First NameLast Name
Position
Email Address
example@example.com
Phone Number

Area CodePhone Number
School Name
Student Population Type
Postal Address

Address

Address 2

CityState

Post Code
Alternate Contact Person
Alternative Contact Person

Alternative First NameAlternative Last Name
Alternative Position
Alternative's Phone Number

Area CodePhone Number
Alternative's Email
example@example.com
Session/Seminar Information
How many seminar sessions do you want to book?
ADD INFO HERE TO EXPLAIN WHAT A SESSION IS
SESSION 1
Possible Dates
In order of preference
Year Group(s)
Number of students for session 1 (approx)
Approx split of sexes if co-ed
Male _ _ / Female _ _
Number of staff attending
Seminar Length
Session Start Time

Hour Minutes

AM/PM Option
Session Finish Time

Hour Minutes

AM/PM Option
School Bell Times
If your bell times are different to the times listed above, please list the bell times here. Please indicate if flexible. EXAMPLE: Start of day: Bell at 8:40 am – Roll marking/PC. First Session 9:00. Morning Tea 10:30-11. Lunch: 12:45-1:15. Final Bell: 3 pm (please finish by 2:50 for messages)
Seminar for session 1
4+ Seminars
Please use the box below to supply details for each session you would like to book.

For each session please include information including:
- Year group(s)
- Number of students (including male/female split if co-ed)
- Number of staff attending
- Seminar name (list below)
- Session length
  - Single Lesson (45-60 mins)
  - Double Lesson (90-120 mins)
  - Full Day
- Start and finish time (or bell times for full day bookings)
Seminars:
- Love & Life
- Consent & Respect
- Getting Real in the Digital World
- Stronger
- Courage
- Parent Session
- PD (Professional Development) Session
Summary of sessions requested
For each session please include information including: Year group(s), number of students (including male/female split if co-ed), number of staff attending, Seminar type, start and finish time (or bell times for full day bookings)/
Seminar Location
Seminar Location
Please Note Specific Instructions to Real Talk team on how to find/access venue.
Please provide our team with more information regarding the location for your sessions.

Pleae mention

1 - Venue type - ie Moveable or fixed seats, tiered seating or flat hall (ie auditorium) or classroom, is there additional space for group activities.

2 - Venue capacity - what is the room capacity when fully seated

2 - Technical setup - please indicate the options avaulable for use in the room - ie sound amplificiation, data projector/screens, whiteboard, raised stage area
Seminar Environment Information
Special Seminar Requests/ Special Consideration
We ask for this information to help us gain a sense of the audience. This may help us tailor the session and allow for sensitivity to trends or incidents within the group.

Please note we don’t necessarily mention many (or any) of these topics in most seminars but trends or ‘red flags’ may guide us to discuss with the school avoiding or addressing certain areas.

We realize this may be hard to do many months in advance, so please contact us in the month before the retreat with any relevant considerations.

We welcome further comments e.g. they are innocent /grownup/Sexualized/ Immature/ large population of specific cultural background.

**Information provided here is kept confidential.
Type a question

Other
Additional information
What led you to book Real Talk

Other
About this Form

This form serves as your intention to book. You will receive a confirmation letter/email to confirm the booking and specific details. If you wish to cancel after this confirmation email or after submitting this form you may incur a fee additional to any expenses already paid for by Real Talk (e.g. flight bookings).

REFER TO TERMS AND CONDITIONS (LINK BELOW) BEFORE SUBMITTING THIS FORM
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Secondary School Booking Form

Contact Information

Alternate Contact Person

Session/Seminar Information

SESSION 1

4+ Seminars

Seminar Location

Special Seminar Requests/ Special Consideration

Additional information