Booking and Eligibility FormPlease fill in the booking form below and email to Spare Parts Puppet Theatre at admin@sppt.asn.au, or fax to 9335 7687.

School Details

School name:

School Address:

Area:Metro Region

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Teacher Name:

Position:

Phone:

Email:

Performance Details

Is this excursion part of your curriculum for 2016-17:Yes No

Show:

Performance Date: Performance Time (10am or 1pm):

How did you hear about Spare Parts Puppet Theatre?

Attendance Details

Number of Students:

Number of Teachers/Helpers:

Year Level/s of Students:

Special Access Requirements:

Has your school visited Spare Parts Puppet Theatre before?Yes No

Has this group of students visited Spare Parts Puppet Theatre before?Yes No

Eligibility Criteria

Location of school:

*what is the distance in km’s from Fremantle of your school? Does your location create challenges for students to attend performing arts programs ie: distance, lack of public transport, isolation from cultural experiences etc.?

Socioeconomic Disadvantage (SEIFA Index of disadvantage score):

*The index is derived from attributes that reflect disadvantage such as low income, low educational attainment, high unemployment, and jobs in relatively unskilled occupations.

Index of community socio-educational advantage (ICSEA) Rating:

*ICSEA provides an indication of the socio-educational backgrounds of students; it has nothing to do with the staff, school facilities or teaching programs at the school.

Cultural and Linguistic Diversity:

*What percentage of students from your school are from culturally or linguistically diverse backgrounds?

Disabilities and/or additional learning needs:

* What percentage of students from your school have disabilities and/or additional learning needs

Additional Information:

* Has your school community been affected by special circumstances such as high local unemployment, drought, flood, bushfire, migration or other destabilizing issues?

Please describe how this cultural experience will benefit your students: