Please fill in all questions below

Week 1: Monday, 4 January - Friday, 8 January 2021
Week 2: Monday, 11 January - Friday, 15 January 2021
Week 3: Monday, 18 January - Friday, 22 January 2021

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* 1. Applicant Details

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* 2. If your postal address is different to your residential address, please enter it below:

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* 3. Please indicate your availability for the 2021 VICSWIM program below:
(Priority will be given to those available for the whole week)

  YES - I am available for the whole week NO - I am unavailable I am only available on certain days
Week 1 (Jan 4th-8th)
Week 2 (Jan 11th-15th)
Week 3 (Jan 18th-22nd)

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* 4. Did you teach VICSWIM in 2020?

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* 5. Is this your first ever year of teaching VICSWIM?

T