School Information

Name of School

Principal Name

Principal Email

Student Nominee Information

Please nominate up to 10 students from Years 10-12, including a mix of student leaders and those who do not have formal leadership roles.

Student 1

Student 1 Full Name

Year Level

Student 1 Dietary Requirements

Student 1 Accessibility Requirements (e.g. mobility assistance, sign language interpreter)

Student 2

Student 2 Full Name

Year Level

Student 2 Dietary Requirements

Student 2 Accessibility Requirements (e.g. mobility assistance, sign language interpreter)

Student 3

Student 3 Full Name

Year Level

Student 3 Dietary Requirements

Student 3 Accessibility Requirements (e.g. mobility assistance, sign language interpreter)

Student 4

Student 4 Full Name

Year Level

Student 4 Dietary Requirements

Student 4 Accessibility Requirements (e.g. mobility assistance, sign language interpreter)

Student 5

Student 5 Full Name

Year Level

Student 5 Dietary Requirements

Student 5 Accessibility Requirements (e.g. mobility assistance, sign language interpreter)

Student 6

Student 6 Full Name

Year Level

Student 6 Dietary Requirements

Student 6 Accessibility Requirements (e.g. mobility assistance, sign language interpreter)

Student 7

Student 7 Full Name

Year Level

Student 7 Dietary Requirements

Student 7 Accessibility Requirements (e.g. mobility assistance, sign language interpreter)

Student 8

Student 8 Full Name

Year Level

Student 8 Dietary Requirements

Student 8 Accessibility Requirements (e.g. mobility assistance, sign language interpreter)

Student 9

Student 9 Full Name

Year Level

Student 9 Dietary Requirements

Student 9 Accessibility Requirements (e.g. mobility assistance, sign language interpreter)

Student 10

Student 10 Full Name

Year Level

Student 10 Dietary Requirements

Student 10 Accessibility Requirements (e.g. mobility assistance, sign language interpreter)

Accompanying Staff Members

Please nominate one staff member for up to seven students, and two staff members for more than seven students.

Staff Member 1 Name

Staff Member 1 Role Title

Staff Member 1 Email

Dietary Requirements

Accessibility requirements: (e.g. mobility assistance, sign language interpreter)

Staff Member 2 Name

Staff Member 2 Role Title

Staff Member 2 Email

Dietary Requirements

Accessibility requirements: (e.g. mobility assistance, sign language interpreter)

Other Notes

Use this section to note any further information such as the names of students who should not be included in the School's photography and/or filming or potential external media coverage of this event.