Please enable JavaScript in your browser to complete this form. - Step 1 of 4School InformationSchool name *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryContact PersonTitleDrMrMrsMsMissName *PositionPhone *Email *NextStart of School *Start of LessonsStart of Break 1 *End of Break 1 *Start of Break 2 *End of Break 2 *End of LessonsEnd of School *Other detailsPreviousNextPlease indicate the number and average size of classes for each year range. Please note that the preferred maximum is 25 students with a limit of 30 for years 3-6. K-2 can be covered in larger groups up to 75, however all students need to be able to see an interactive whiteboard (or similar). Schools can now choose to have a session per K-2 class rather than having larger year level groups. If your classes are composite classes spanning across the year ranges below (eg 2/3 or 4/5), please select the year range you would like us to focus on and make a note in the comments section. Please list only those classes you wish to be involved in the St John ACT First Aid in Schools Program.Which classes will be participating in the FAiS program? *Junior Primary (Years K to 2)Middle Primary (Years 3 & 4)Senior Primary (Years 5 & 6)Number of Kindergarten groupsApprox. size of each Kindergarten groupNumber of Year 1 groupsApprox. size of each Year 1 groupNumber of Year 2 (or Year 1/2) groupsApprox. size of each Year 2 (or Year 1/2) groupFurther detailsNumber of Year 3 groupsApprox. size of each Year 3 groupNumber of Year 4 groupsApprox. size of each Year 4 groupNumber of Year 3/4 groupsApprox. size of each Year 3 /4 groupFurther detailsNumber of Year 5 groupsApprox. size of each Year 5 groupNumber of Year 6 groupsApprox. size of each Year 6 groupNumber of Year 5/6 groupsApprox. size of each Year 5/6 groupFurther detailsFurther informationSpecial NeedsAre there any students with special needs that we need to be aware of? *YesNoPlease provide details *PreviousNextDates are assigned to schools on a first come first served basis. While the website is updated frequently, there is no guarantee that the dates you nominate will still be available at the time of submitting this form. If this is the case, the Program Coordinator, Twisty, will contact you via email. Please nominate some extra dates that would be suitable below to allow for flexibility. Year K-2 presentations take 45-60 minutes Year 3-4 Classes take 60 minutes Year 5-6 classes take 60-70 minutes depending on time available. All usual school breaks will be observed. Some sessions may need to be split across school breaks depending on your school timetable. K-2 classes have no firm maximum on students providing all can see an interactive whiteboard (or similar). These sessions can be per class group or per year level with a suggested maximum of 75. Year 3-6 classes are limited to 30 students (although a maximum of 25 is preferred).DatesPlease nominate up to 10 dates that may be suitable for your school in order of preference. You will need to nominate at least one day per 4 courses/presentations plus an alternative date for flexibility in scheduling. Confirmation of your dates will be sent to the email address nominated at the start of this form. A training agreement will also be sent. This will need to be printed, read, completed, signed and faxed or emailed back to lock in your booking.Course Date 1 *Comments or notesCourse Date 2Comments or notesCourse Date 3Comments or notesCourse Date 4Comments or notes Course Date 5Comments or notesCourse Date 6Comments or notesCourse Date 7Comments or notes Course Date 8Comments or notesCourse Date 9Comments or notesCourse Date 10Comments or notesPreviousWebsiteSubmit