THE NONA LEE SCHOOLS EDUCATION PROGRAMME BOOKING REQUEST FORM

Please complete the form below for booking for The Nona Lee Schools Education Programme. In order to obtain the maximum benefit from your visit, the duration of the educational programme is 2 hours and 15 minutes. Special schedule arrangements are possible upon request.

Nona Lee Schools Education Programme Booking Request Form

School: *		Teacher :*
Address: *		Contact Telephone: *
		Mobile Telephone: *
City: *		Email Address: *
State/province: *
Country:
Post/Zip code: *
Number of students: *		Number of teachers: *
Year Level: *
Area of Study: *	20th century history	Special requests/needs:
	Religion and society
	English - Please specify name of text below:
	Other - Please specify below:
Date & Time: *
Choice #1	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / 1 2 3 4 5 6 7 8 9 10 11 12 / 2009 2010 2011 2012 - Fri 9:30am Mon-Thur 10:00am Fri 12:00pm Mon-Thur 12:45pm
Choice #2	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / 1 2 3 4 5 6 7 8 9 10 11 12 / 2009 2010 2011 2012 - Fri 9:30am Mon-Thur 10:00am Fri 12:00pm Mon-Thur 12:45pm
Choice #3	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / 1 2 3 4 5 6 7 8 9 10 11 12 / 2009 2010 2011 2012 - Fri 9:30am Mon-Thur 10:00am Fri 12:00pm Mon-Thur 12:45pm
SESSION TIMES:	MON – THUR: 10AM - 12.15PM, 12.45 - 3PM
	FRI: 9.30M - 12PM OR 12PM - 2PM.
		Compulory fields are marked with an *