Family Science Nights Form

Thank you for your interest in PrimeSCI! Family Science Nights. Please complete the form to organise your Family Science Night for 2025. Note: This form collects data using a third-party provider (Airtable) and you consent to this by completing the form. The data we collect is treated in accordance with Swinburne's Privacy Statement. You can unsubscribe at any time.

Teacher's Name

Email address

Phone number

Mobile

School name

{name}

School address

Suburb

Postcode

School ABN (for new schools only)

Email for Finance Department/ Accounts Manager

FSN Topic

FSN- Lesson Format

Classroom Style (60 students with one parent) - 1 session
Carnival Style (up to 90 students with one parent) - 1 session
Carnival Style (up to 90 students with one parent) - 2 sessions

First preferred incursion date

Second preferred incursion date

Questions or special requirements

{name}

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