APPLICATION FORM
This is not an electronic form. Complete it online, print it and post to: 
Ken & Sue Page
12 Dyson Drive Norah Head NSW
Wk. Ph. (02) 43922711 Hm. Ph. (02) 43966485
suepage@ozemail.com.au

PASTA OVERSEAS TOUR

YEAR INTENDING TO TRAVEL:

A. I wish to apply to attend as a:

Student Representative Adult Delegate Supervising Adult

B. The name of the group I will represent is

C. My position in or role with this group is

D. My SRC Adviser is

E. My / our contact details are as follows:

Mailing Address

Phone Fax

Email (if available)

F. Name of Parent / Guardian approving this application

Signature of Parent / Guardian

Date:

G. Name of Principal who is aware of this application

Signature of Principal

Date:

H. What experiences in student leadership and representation do you have? Why do you wish to go on this tour? Why do you think you are a good candidate to represent your country on this tour?

ATTACH YOUR RESPONSES TO THESE QUESTIONS ON A SEPARATE PAGE