Type of Program: Day Program Residential Camp
School Phone Number:
Alternative Contact Number:
School Fax No:
Student Numbers: Year Level:
Please indicate the time of year you would like to attend camp or day program by term / month of the year. Please choose your preferred times, starting from 1 – 3 to indicate the time you would like to attend.
1) Term Month Year
2) Term Month Year
3) Term Month Year
Please copy the CAPCHA code you see above into the text field
© The State of Queensland (Department of Education, Training and Employment) 2016.