MyRoad School Interest Form

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BOOKING FORM

To request a MyRoad session for your school, please complete the form below. ¬†Bookings are not final until confirmed by the MyRoad team. Use ‘tab’ to move between fields in this form.

MyRoad 2017/18 - School Booking Request
Paste home page URL
Street
Suburb
State
First name
Last name
Best days/time to contact
Email (a copy of this form will be sent to this address)
Area Code
Number (and extension, if applicable)
Mobile
Note: bookings are open only for female students aged 16 to 19 or turning 16 that year.
Select a group size of 3 or 4 students to each mentor.
Session duration is strictly 2 hours
(ie AEST/ADST/ACST/AWST)
Provide any additional information, such as class demographics, which may be useful to our mentors, or ask a question.
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