NOTE: please use your own email address when completing the first part of the form, Junior Ambassador. Your parent/guardian's email is for the second part of the form.

What is your first name, future Junior Ambassador?

What is your last name, future Junior Ambassador?

What is your email?

Please select your current school year Year 5 Year 6 Year 7

What is your date of birth?

Your mailing street address

Your mailing city

Your mailing state WA

Your mailing zip/postcode

I have received parental/guardian permission to enrol in the Junior Ambassador program

Parent/Guardian’s name

Parent/Guardian’s mobile number

Parent/Guardian’s email

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