Register for Amnesty International's Freedom Challenge 2017

Please complete this form to register and order your resources for Freedom Challenge 2016

YOUR AMNESTY INTERNATIONAL YOUTH GROUP

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* 1. Name of Youth Group / School

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* 2. Number of members in your group?

5-11

11-20

21-50

76-100

101+

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* 3. Number of students on your school's roll

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* 4. POSTAL ADDRESS OF SCHOOL

Name

Address

Address 2

City/Town

ZIP/Postal Code

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* 5. TEACHER COORDINATOR DETAILS

Name

Email Address

Phone Number

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* 6. STUDENT COORDINATOR DETAILS

Name

Email Address

Phone Number

USE OF PHOTO PERMISSION

I give Amnesty International permission to use my photograph and details for future promotional activity (i.e. newsletters, publications, social media, website, videos). I also give permission to Amnesty International to release my photograph to third parties (i.e. newspapers, television networks)

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* 7. Photo Permission

Yes

EVENTS AND ACTIONS

If you know the details of your event/s please provide them below. If you unsure what you will do for Freedom Challenge please note that below and we will contact you closer to the time. Remember that Freedom Challenge week is Monday 7 August - Saturday 12 August but events/actions can be held anytime in Term Three!

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* 8. Date range of event/s

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* 9. Details of your event/s

YOUR RESOURCE REQUIREMENTS

We will do our best to meet the numbers that you request, but please note we do have limited supplies of all resources.

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* 10. How many Amnesty International badges do you require? (Come in bags of 50. We recommend that these are given out in return for a koha/donation as a fundraiser)

100

150

200

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* 11. How many Amnesty International stickers do you require? (Come in rolls of 250 but we can cut up for you)

100

200