Write-A-Book-In-A-Day

Application Form

Children's Hospitals Australia
Katharine Susannah Prichard Foundation

Not Applicable in 2008


Supervisor/Team Leader
Team Name  
Entry Category Primary Secondary Open
Supervisor Name  
Organisation  
Street  
Suburb  
State   Postcode  
Telephone  
Email  
Preferred Date  
Entry and Donation Children's Hospital: $
I am the Supervisor/Team Leader in charge of the above team and undertake to exercise all duty of care and to ensure that I and the team comply with all rules of this competition
Signature  

Team Members
 
Name
Signature
1    
2    
3    
4    
5    
6    
7    
8    
9    
10    
By signing the above, each member of the team agrees to comply with the rules the competition and to abide by the decisions of KSPFBC and the judges


Sponsors
Name
Address
Separate
Receipt YN
     
     
     
     
     
     
     
     
     
     
     
     
     
     

Copyright Ownership details if not owned collectively by the team  

Participating Children's Hospitals in Australia

Sydney Children's Hospital Foundation, New South Wales
Royal Children's Hospital Foundation, Queensland
Women's and Children's Hospital, Foundation, South Austrlaia
The Royal Children's Hospital Foundation, Victoria
Princess Margaret Hospital Foundation, Western Australia

 

Please Send Application Form and Cheques or Money-Order
to
KSP Foundation
Write-A-Book-In-A-Day
11 Old York Road
Greenmount
WA, 6056

 

Optional Invoice