Small Grant Kid's Think Tank application

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* 1. Child's name

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* 2. Are you available on Thursday 30 September from 8.30am - 5pm?

Yes

No

Other (please specify)

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* 3. What grade are you in?

3

4

5

6

7

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* 4. What school do you go to?

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* 5. What council area do you live in?

Brighton

Southern Midlands

Derwent Valley

Central Highlands

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* 6. Tell us why you want to be involved (max 250 words)

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* 7. We can pick you up and drop you back off - do you need a lift to the day?

Yes

No

Other (please specify)

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* 8. What's your parent/carers' contact name and number?

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* 9. Do you have any dietary requirements we need to know about?

Yes

No

Other (please specify)