Woodside Scitech Science Awards 2016

Page One

1. School Name *This question is required.

2. Postal Address *This question is required.

3. Suburb *This question is required.

4. Postcode *This question is required.

5. State *This question is required.

6. Region *This question is required.

7. Phone *This question is required. This question requires a valid number format.

8. Contact teacher’s name *This question is required.

9. Contact teacher’s position

10. Contact teacher’s phone (if different from above)

11. Contact teacher’s email *This question is required. This question requires a valid email address.

12. Optional

I require an additional award pack (two extra awards) as we have two year groups graduating
I would like to register for Scitech Teacher E-news

If you would like to request a representative to attend your graduation ceremony, please fill out the separate form on our website.

TERMS AND CONDITIONS
I am aware that these awards are to be presented to our graduating primary students. I agree that by enrolling our school in the Woodside Scitech Science Awards, I may be contacted by Scitech for further information and feedback. Any information collected for the purposes of this project will be retained by Scitech and Woodside and not distributed to any third parties.**

13. Do you agree to these terms and conditions *This question is required.

**Scitech respects your privacy. Personal information collected by us will remain confidential and is never shared with third parties without your knowledge. Please visit www.scitech.org.au for a detailed privacy statement.