2016 Rotary District 9675 Interact Conference Student Registration
The 2016 District 9675 Interact Conference is to be held at UTS Aerial Function Centre on Monday 2 May 2016 from 8:30am to 3:30pm. The event is being organised by a Committee of Rotaractors from District 9675 and is sponsored by Rotary District 9675.

This Conference will bring together Interactors and other students with leadership potential for a day of personal development, team­building and networking. The theme of this year's conference is "Growth". We have an impressive line-­up of speakers and team activities, so register now to make sure you don't miss out!

The following form is for students interested in attending the Interact Conference. If you would like to attend, please speak with your school's Interact Co-ordinator to ensure you have permission. If you, your school's Interact Club Co-ordinator or your local Rotarians have any questions, please email Elizabeth at miss.ehuynh@gmail.com

IF YOU ARE A ROTARIAN OR ROTARACTOR, a separate registration form is available at tinyurl.com/interactconferencevolunteers

Full name *
Your answer
Name of high school *
Your answer
Email *
Your answer
Mobile phone number *
Your answer
Emergency Contact (Name) *
Your answer
Emergency Contact (Relationship) *
Your answer
Emergency Contact (Phone number) *
Your answer
Dietary Requirements *
Grade *
What position are you in your Interact Club? *
Please note your answer does not affect your ability to attend the conference
Required
In 50 words or less, tell us about your most memorable Interact moment ?
Your answer
What would you like to learn or gain from the conference?
Your answer
*
Required
*
Required
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