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Application Form: First Hand

First Hand: Drawing and Talking with Vernon Ah Kee
Friday 21 February | 4.30pm - 6.30pm

This is a FREE program, but limited places available.

The program is open to students in years 9-12, and young people under 18 years.

Aboriginal and Torres Strait Islander students are encouraged to apply.

C-A-C will contact you and your parent/carer on Friday 14 February (or earlier for early applicants) to confirm whether you have been accepted for this program.

Applications Due:  5pm, Monday 17 February
Enquiries: Feel free to contact Edwina Hill, Education Officer either over the phone, email or face to face, for more information or to discuss different ways to apply.

Edwina Hill
Education Officer
(02) 4645 4298 | 0419 213 872
[email protected]

Student Details

Name*
School
Grade
Do you identify as Aboriginal and Torres Strait Islander?
What is your cultural background?
Suburb
Phone
-
E-mail*
Please include any medical requirements, allergies or access needs that might affect your participation in the program. This information is for planning and safety purposes only.
Dietary requirements
How did you hear about this program? (Please include teacher’s name if applicable)
Student Application Question
Why would you like to join First Hands with Vernon Ah Kee, at Campbelltown Arts Centre? *
Parent/Carer to Complete
Name *
Phone *
-
E-mail
Emergency Contact Details
Name *
Phone *
-

Photo Permission
I  do hereby grant permission to Campbelltown City Council c/- Campbelltown Arts Centre to use the image and likeness of my child as outlined below:

Recordings and images from this program may be edited and used to publicise and promote Campbelltown Arts Centre, or as part of reporting requirements for funding.

Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of participants (including Your Child) for use in materials that include, but may not be limited to, printed materials such as brochures and newsletters, videos, and digital images such as those on the Campbelltown City Council and Campbelltown Arts Centre website.

This permission applies to workshops, performances and other activities conducted by C-A-C. I acknowledge that if at any stage I no longer wish for My Child’s images to be used, I will notify the Arts Centre in writing via email to [email protected]

*

Disclaimer
The personal information provided on this application form will be used and disclosed by Campbelltown Arts Centre for general administration and communication, or for any purpose required or permitted by law. This information will be held securely and disposed of when no longer needed.

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