Thanks for your interest.

This program is for students who will be in Year 10 in 2019, and who have participated in the Outdoor School's Future Makers program during the 2019 school year.

This application form is the first step in the process of selection of students for this experience by Outdoor School.

Completion of this form does not mean that a students is successful in their application to join this experience.

Please complete all questions in this form and submit. PLEASE ENSURE EMAIL ADDRESSES AND PHONE DETAILS ARE CORRECT.

Feel welcome to write as much as you like for each answer.

Offers will be made in the first week of December 2018.

For more information, see our website: http://www.outdoorschool.vic.edu.au/extension-programs/2455/ or email Paul Hartley: hartley.paul.j@edumail.vic.gov.au

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* 1. Email address

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* 2. Your School

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* 3. First Name

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* 4. Surname

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* 5. Parent or Carers Names

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* 6. Parent or Carers Email Address/s

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* 7. Parent or Carers Phone Number/s

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* 8. An extension program of this nature is a serious undertaking, explain why you want to be part of the Kimberley Cultural Experience.

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* 9. 18 days in a small group can be a challenging experience. Explain what you can contribute to the group during the Kimberley program?

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* 10. Explain some of the things you are hoping to learn from being part of an extension program living with the Nyikina/Mangala people in the remote Kimberley region of Western Australia?

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* 11. Aside from small group skills what other attributes do you possess that would enable you to successfully participate in a trip of this nature?

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* 12. This experience does include the need to undertake some tasks before during and after the trip. Are you able to commit to doing the set tasks with a high degree of attention to quality?

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