First Aid in Schools Program Booking Form

This form is for Victorian Primary Schools. If you are a Kindergarten or Early Learning Centre interested in the program, complete an Expression of Interest (EOI) here to go on the waitlist.

Your Information

Your information

Please fill out your information. This is so we can contact you to confirm your booking.

First name *

Last name *

Mobile number *

Email *

School information

General contact information for your school

School name *

Phone number *

Street address & Suburb *

Postcode *

School hours

School start time *

School finish time *

Recess start time *

Recess finish time *

Lunch start time *

Lunch finish time *

Number of classes participating (Minimum of 90 students needed)

Number of classes participating

Please put the total number of classes that will be participating per grade. Minimum of 90 students is needed for a booking, and a maximum of 40 students per session.

Which class groups will be participating? *

Prep/Foundation

Grade 1/Grade 2

Grade 3/Grade 4

Grade 5/Grade 6

I confirm that I have a minimum number of 90 students participating and will configure groups so that each 45-minute session contains a minimum of 25 students *

Yes

Less thank 90 pop up

Please note: It is a requirement for this program that all bookings (excluding Rural Schools) have a minimum number of 90 students.

Prep/Foundation

Prep total number of classes *

Prep total number of students *

Grade 1/Grade 2

Grade 1: Total number of classes *

Grade 1: Total number of students *

Grade 2: Total number of classes *

Grade 2: Total number of students *

Grade 3/Grade 4

Grade 3: Total number of classes *

Grade 3: Total number of students *

Grade 4: Total number of classes *

Grade 4: Total number of students *

Grade 5/Grade 6

Grade 5: Total number of classes *

Grade 5: Total number of students *

Grade 6: Total number of classes *

Grade 6: Total number of students *

Class and session Summary

Total number of classes requiring sessions (Large bookings may need a number of consecutive dates) *

Preferred date of booking

Preferred date description

Please select 2 preferred date options that are clear in your school's calendar from the options below, and we will do our best to accommodate. TERM 3 & 4 NOW OPEN

All dates are subject to availability.

September availabilities - 2, 9, 18

October availabilities - 5, 8, 9, 15, 16, 29, 30

November availabilities - 2, 6, 10, 11, 12, 13, 16, 18, 20, 23, 25, 26, 27

December - all dates available

First Preference Date *

Second Preference Date

Comments - Please select one module option for each year level: either the Standard Module or one of the Alternate Modules. Details for each module are outlined below. (Standard modules are recommended for schools who have not participated in the program before) *

FASCH module image

So we can best equip our trainers please describe any behavioural/special needs requirements in this cohort *