Yarra Valley Water – School Incursion booking request
School details
School name
Street address
Suburb
State
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Postcode
Contact details
Contact name
Position at school
-- choose --
Teacher
Principal
Subject Coordinator
Environment/Sustainability Coordinator
Other
Email address
School phone number
Where did you hear about our program?
-- choose --
Yarra Valley Water website
Mail out
Word of mouth
Curs!ion website
Other
Presentation options
Please select the year level(s) you wish to have presented to?
Prep
1
2
3
4
5
6
Please select your preferred activity/activities:
Primary
Primary – Choose Tap – better for your health and the environment
Lower Primary – The Big Book About Water
Upper Primary – All About Water
Primary – Other (please specify topic(s) of interest and required length of presentation)
Is there any equipment you will
not
be able to provide?
Laptop
Projector
Screen
Preferred dates
Please indicate up to 3 preferred dates for the presentation(s). You will be contacted to confirm your presentation dates and times.
Preferred date 1
Preferred date 2
Preferred date 3
Presentations and times
How many presentations would you like?
1
2
3
Please indicate a preferred time for the presentation(s). If you have a special requirement for the presentations to be on separate days please note the date/times in the comments box below.
1st presentation time
2nd presentation time
3rd presentation time
Comments
