Presentation Enquiry Form

School / Organisation name: *

Your role at school / Organisation: *

Given Names *

Family Name *

Email Address *

Phone Number *

Address *

Street number *Street name *

City *

State *

Postcode *

Country *

Send me a quotation *

Face-to-Face or Zoom *

Face-to-FaceZoom

Interested in the following presentation/s *

1. Clearing the Air Vaping 2. Abuse is NOT Love3. Coercion is NOT Consent4. Respectful Relationships 5. Conquering Academic Anxiety & Stress6. Paw Prints With Zayda

Is one of these presentations a refresher presentation. (In other words, have I presented the same presentation to this year group in a previous year) *

No, you have never presented this presentation to this year's group.Yes, you have presented this topic to this year's group. We are rebooking it as a refresher.

Explain the above answer if needed:

How many sessions are you interested in *

One Session StudentsTwo Sessions StudentsThree Sessions StudentsFour Sessions StudentsFive Sessions StudentsParent Session (Face-to-Face or Zoom)Staff Session (Professional development)

Year group/s *

KindergartenYear 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12

How many participants: (Estimate) *

Will the sessions be on more than one day if it is multiple sessions (this will effect travelling cost) explain your needs. *

Please give me a minimum of 3 potential dates so I can check my diary. Include times you are looking at as well. *

If I am booked on your suggested dates. What days of the week is best for you so I can check my availability. *

MondayTuesdayWednesdayThursdayFridayAny day

Where did you hear about Azelene's presentations *

Azelene work alongside her Therapy dog Zayda, who is availible to join her at presentations if there is a need. Let us know with a Yes, No, We don't mind, if you would like Zayda to attend or not. *

Yes, she is welcome.No, thank you, it's not a suitable venue.We do not mind your choice if you would like to bring her.We will think about it and let you know.Can we chat with you about it before we decide?

More information you would like to add

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