Student's
Name _____________________________________________________
Male/Female
_____ Year Level _______
School
_____________________________________________________________
School
Address ______________________________________________________
School
Contact Person ________________________________________________
School
Telephone ____________________ School Fax ______________________
Email
_____________________
Principal's
Name __________________ Principal's Signature _________________
Student's
Home Address _____________________________________________
_____________________________________________________ Postcode
______
Home
Telephone _____________________ Fax
____________________________
Email ____________________________ Mobile
Ph _________________________
Parent/Guardian's
Name _______________________________________________
Parent/Guardian's
Signature ____________________________________________
Please
tell us
Why do you wish to attend this Conference?
What can you contribute to the Conference?
Attach your ideas to your completed application form.
Conference
fee
5 days residential (includes all meals) $550
Deposit
A $100 non-refundable deposit MUST accompany this
application, which is due by 31 March, 2002.
Early Bird conference fee: $500, if paid in full by 31st March,
2002
NB:
All fees must be paid in full by 31 May,
2002.
Only students selected by their school as school delegates are
eligible to apply.
No students can attend the conference as day visitors.
We will notify you if you have been accepted.
Principal
or Principal's representative:
Please
make cheques payable to: Creating a Sustainable Future Conference
Send
to:
Dr. Caroline Smith
School of Education
Australian Catholic University
Locked Bag 4115 Fitzroy VIC 3065
Enquiries:
Email c.smith@patrick.acu.edu.au
Ph (03) 9953 328
Fax (03) 9953 3475
www.
earthinc.vze.com