Booking Form - High School Outreach Programs

STUDENT STUDY VISIT and LECTURE BOOKING FORM

Please note: please ensure that all fields marked with an asterisk are completed

Please nominate your preferred dates and times for when the Program should take place:

1st Preferred Option

2nd Preferred Option

3rd Preferred Option

Date *:

Time *:

Date *:

Time *:

Date :

Time :

At BJE At School

Number of Lectures *:

Name of School *:

School Address 1:

School Address 2:

State:

Post Code:

Contact Person *:

Phone No.:

Mobile No.:

Fax No.:

Email Address *:

Number of Students *:

Number of Teachers:

School Year *:

Topic for Lecture *:

Do you wish to have a synagogue visit integrated into your Program?:
Yes No

Do you wish to visit the Australian Jewish Museum as part of your Program?
Yes No

If visiting the Museum, do you wish to tour the entire Museum (includes Australian Jewish History and Jewish Studies) or just the Holocaust section?
Entire Museum Holocaust section

Is lunch required:
Yes No

Do you wish us to to arrange for lunch, which can be collected from one of the local Israeli Restaurants? Cost $11 per person – payment details on application.
Please Arrange lunch No Thank You

Fee for Student Study Visit $12 per High School student - payable to Academy BJE (fee may vary according to the number of presentations and/or length of time for the lectures).
Fee for Jewish Museum $10 per student, payable to The Sydney Jewish Museum. Fees for Lecture Visits to both Primary and High Schools may vary and are available on application

Name of Authorised Booking Teacher *:

Position at School *:

Any other Comments:

Booking Form - High School Outreach Programs

(includes programs for Studies of Religion Students)