Altitude Day Registration Form

School/Organisation Name: *

Contact Person: *

Position:

Phone Number: *

Fax Number: *

Email: *

Invoice Address

Addressed To: *

Address: *

State: *

Postcode: *

Please Select Your Altitude Day (Year 9)

Altitude Day (Year 9):

Toowoomba - Wednesday 26th October 2011

Newcastle - Monday 31st October 2011

Sydney - Wednesday 2nd November 2011

Sunshine Coast - Monday 28th May 2012

Brisbane - Tuesday 29th May 2012

Gold Coast - Thursday 31st May 2012

Sydney - Monday 4th June 2012

Melbourne - Tuesday 5th June 2012

Adelaide - Wednesday 6th June 2012

Number of student places to reserve: *

Number of teachers likely to attend (staff complimentary):

Invoicing

Invoice: *

I understand an invoice will be generated upon receiving this registration form and sent to my school/organisation.