Instructions:
To request a visit by Dr Samantha Lloyd to your school for Science Week, 12- 16 August, fill in the information below.
You can ask for up to three 60 min sessions per day.
Maximum 60 children per session.
Please make sure you supply an alternative date to help us with allocations to schools.
You will be sent confirmation of your booking and other relevant information from the 1 June. This will all be sent via email.
Submit your booking request before 28th March for the first round of bookings. Any coming in after that date will be allocated to spaces available.
* indicates required field
Name of school contact person*
Email address*
Please confirm your email address*
School name*
School street address*
School postcode*
School phone number*
Preferred day and date*
In case your first choice is booked out, please select an alternative day and date:
Alternative day and date*
Session 1: Number of students
Session 1: Year level
Session 2: Number of students
Session 2: Year level
Session 3: Number of students
Session 3: Year level
Additional comments
