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Incursion EOI Form

Centre/School Information

Centre/School Name:

Centre/School Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

LGA of Centre/School:

If unsure, please check the 'Know Your Council' site: https://www.vic.gov.au/know-your-council

Organiser Information

Key Organiser Name:

First Last

Key Organiser Email:

Key Organiser Phone:

Request Details

Number of groups:

Does your Centre/School have the following:

Select all that apply

Compost Bin

Worm Farm

Incursion day preferences:

Select all that apply

Monday

Tuesday

Wednesday

Thursday

Friday

Operating hours for groups:

Monday

Tuesday

Wednesday

Thursday

Friday

Further Details:

Is there any further info you would like to share?