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EnviroMentors School Registration Form - Fairfield

Fairfield City Council

Thank you for your interest in EnviroMentors! Thanks to the Fairfield City Council, participation in the program is completely free for your school - please register your schools' details below.

1. School Name *This question is required.

2. School Address *This question is required.

3. Phone Number

4. Contact Teacher *This question is required.

First name
Surname

5. Contact Email *This question is required. This question requires a valid email address.

6. Principal Name *This question is required.

	First name
	Surname

7. Principal Email Address (sign-off required for booking confirmation) *This question is required. This question requires a valid email address.

8. Number of Classes Per Stage

This gives us an indication of how many sessions/days your school needs, as we take one class (maximum 35 students) per workshop. *This question is required.

Early Stage 1
Stage 1
Stage 2
Stage 3
Mixed (i.e. small school)

9. Incursion Dates

EnviroMentors will be visiting your area in Term 4, 2026 and Term 1, 2027. Indicate your preferred weeks* (you may select more than one).

*Please note that we cannot guarantee your preferred dates or week due to the number of registrations we receive. Unless dates are indicated as "unsuitable" in the next question, your school may be allocated any of the dates within the entire given time frame below. *This question is required.

10. Please indicate any date(s) which are unsuitable for your school.

Any and all unsuitable dates within the entire time frame (above) need to be indicated, otherwise it will be assumed they are suitable. *This question is required.

11. Incursion Topics Available

Your local council is offering a choice between the following modules, which reflect current issues in your LGA. Please indicate which one you would like delivered.

More details about modules can be found on the registration email through which you accessed this form. *This question is required.

12. Does your school have a current Return and Earn collection scheme? Please provide details, if possible: *This question is required.

Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.

13. How did you hear about the program?

Email Campaign
Phone Call
The Local Council
Word of Mouth
Other Please enter an 'other' value for this selection.

Thank you for registering with EnviroMentors. We will be in touch when registrations close with dates allocated to your school. If you have any questions in the meantime, please call our team on (02) 8594 4000 or email Shani at spatel@kabnsw.org.au