FULL STEaM AHEAD - Sign Up Form - July 8-12th 2019
Places are limited! – Applications Close June 21st 2019 (Late applications may be accepted)
Name: *
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School: *
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Email: *
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Contact Number: *
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Teacher Referee Name: *
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Teacher Referee Contact Email: *
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Teacher Referee Contact Number: *
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Emergency Contact Name: *
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Emergency Contact Number: *
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Relationship With Your Emergency Contact: *
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List any relevant medical issues *
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Dietary Requirements (ie. allergies, halal, vegetarian) *
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Please tell us why YOU would like to participate in this workshop in 100 words or less: *
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Commitment agreement: If selected, you will need to commit to attendance at all days of the program. *
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