YOUTH CHALLENGE PROGRAM 2010

Application Form

Please complete the form below to apply for the 2010 Youth Challenge. Fields marked with a asterix (*) are mandatory.

School Details

School * Phone *
Address * Fax
Suburb * Email *
State *
Postcode
Principal

Teacher details

Name * Teaching area(s)

Student details

Name Year level Name Year level
1   5  
2   6  
3   7  
4   8  

Venue

I nominate the students and teacher(s) named above to represent our school a the DEFENCE 2020 Youth Challenge at:

*

 
Dates and locations:
  
Mon 19 Apr — Townsville QLD
Tue 20 Apr — Brisbane QLD (FULL)
Wed 21 Apr — Gold Coast QLD
Wed 28 Apr — Parramatta NSW (FULL)
Thu 29 Apr — Canberra ACT (FULL)		 Fri 30 Apr — Wagga Wagga NSW
Mon 03 May — Geelong VIC
Tue 04 May — Melbourne VIC (FULL)
Thu 06 May — Hobart TAS (FULL)
Fri 07 May — Launceston TAS 		Mon 07 Jun — Katherine NT
Tue 08 Jun — Darwin NT
Thu 10 Jun — Adelaide SA (FULL)
Mon 28 Jun — Albany WA
Tue 29 Jun — Perth WA (FULL)

Additional information

If you are uncertain of the number of students attending, have special food reqirements for your school or have any other information to include on the application form please do so here. Regional schools may be able to bring more than 6 students, please include a request for additional students below.

User validation

Please enter the code shown in the picture: *

 

* Mandatory fields.

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