High School Performance Booking Form

Application form

If you are a teacher and would like to book The Teenage Alchemist fill out the form below.

Please note that a 24 hour clock is used for the time section.

Required fields are marked with an asterisk *

First Name:*

Last Name:*

Position:*

Email address:*

Phone:*

Alternate Phone:
Address:*

Suburb:*

State:*

Postcode:*

My local CQ:*

Would you like to be kept informed about Camp Quality?

Yes No

Name of school:*

Please provide school hours (School start & finish, Recess start & finish, Lunch start & finish): *

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