Bookings Incinerator Education Program Booking Please complete this form to request your student excursion to the Incinerator Gallery. The information you provide here will help us to plan for your visit.Main teacher contact for excursion* First Last Email* Phone numberWhen are your preferred dates to visit?Please check the exhibition schedule on the website to ensure the Gallery will be open.First Choice* DD slash MM slash YYYY Time*10:00am11:00am12:00pm1:00pm2:00pmSecond Choice* DD slash MM slash YYYY Time*10:00am11:00am12:00pm1:00pm2:00pmSelect a tour type:*What is Art?Community, Change and CreativityExhibition ViewpointsLooking to WriteUnderstanding Art - Ideas, artworks & exhibitionsConnecting Art - Curate, design and proposeOther - please specify in text box belowSchool Name*Student Year Level*KinderF123456789101112TAFE / TertiaryAnticipated number of students*Anticipated number of teachers (and other chaperones)*Do you have any specific learning goals for this visit? Is there any other relevant information we should be aware of?Is there anything, in particular, you would like the students to gain from this experience.How did you find out about Incinerator Gallery Education Programs? Promotional postcard Email/enews Printed program Council website Facebook/social media Word of mouth Other How will your students travel to the Incinerator Gallery?Would you like to subscribe to the Education e-news?* Yes please No thanks Need help to complete this form?Contact incinerator@mvcc.vic.gov.au or phone 03 9243 1750We are a child safe organisationMoonee Valley City Council is committed to being a Child Safe Organisation (ccyp.vic.gov.au/child-safety/being-a-child-safe-organisation/) with zero tolerance for child abuse, and will protect the interests and safety of children at all times in accordance with the Victorian Child Safe Standards (ccyp.vic.gov.au/child-safety/being-a-child-safe-organisation/the-child-safe-standards/) and related legislation. Verbal permission is acceptable for photo/video/film or interview subjects over the age of 16. For photo/video/film subjects aged 16 years or under, OR subjects requiring support with decision-making, this form must be completed by their parent/guardian/carer.Privacy StatementMoonee Valley City Council (Council) is collecting your personal information through this form in order to obtain your permission to use your photo/video/film or interview for publication on our website, social media channels, print media, advertising, etc. Your information and your child’s information will be stored in Councils document management system. Council will not disclose your personal information without your consent, except where required to do so by law. Contact privacy@mvcc.vic.gov.au to request access to your personal information. For further information on how your personal information is handled, refer to Council’s Information Privacy Policy (mvcc.vic.gov.au/utilities/privacy).
