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Education Booking Form
Please fill out the booking form below, and ensure you fill out as many fields as possible. A staff member will respond shortly with a booking confirmation. Cheques are to be made out the the
Ararat Rural City.
Contact Name
Phone
Email Address
Mobile Phone
Group/School Name
Fax
Postal Address
State
VIC
SA
NSW
ACT
QLD
NT
WA
TAS
City
Postcode
Booking Date
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
2007
2008
2009
2010
No. Students
Booking Time
9:00am
9:30am
10:00am
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
until
10:30am
11:00am
11:30am
12:00pm
12:30pm
1:00pm
1:30pm
2:00pm
2:30pm
3:00pm
3:30pm
4:00pm
4:30pm
No. Adults
Year Level
Please Select
Prep
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Year 7
Year 8
Year 9
Year 10
Year 11
Year 12
TAFE
University
Other
Age of Students
years of age
Further Comments
Phone: 03 5352 1078 | Email:
info@gumsan.com.au
| Fax 03 5352 4906
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