REGISTRATION FORM

Get into IT Round Table Dinner

Youth Registration

Attendance at the Get into IT!! Round Table Dinner is free for regional youth only (up to 21 years of age). All other participants should register using the Industry Participant Registration Form.

Questions marked with a * are required.

*1.	First name:

*2.	Surname:

*3.	Date of Birth

*4.	School (if not applicable type "nil"):

5.	Campus (if applicable):

6.	Year Level:

*7.	Telephone:

*8.	Email:

9.	Name of your Careers Teacher:

10.

Are you currently undertaking IT units at School

Yes

No

11.	If yes, what units are you undertaking?

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