Food Smart Families Program Registration

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* 1. School /Centre Name

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* 2. School/Centre Address

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* 3. Contact Details

Contact Name

Contact Phone

Contact Email

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* 4. Preferred start date/Term? (you need 3-4 weeks to run the Food Smart Families Program)

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* 5. Estimated number of families attending your School / Centre

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* 6. Schools only please answer this question; (Early Childhood Centres select NA)

# of students participating in the Food Smart Families Program

Year level of students participating in the Food Smart Families Program

Name of group i.e. Year 7 science, environmental group, student council

NA

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* 7. Do you have interest in hosting a free Bees Wax Wrap making workshop for actively participating families/staff/students or would you prefer to have Food Smart produce bags as give aways?

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Thank you for your interest. We will be in touch soon!