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Competition Entry Form

Please complete this form and include it with your entry, electronically via webkeeper@racismnoway.com.au, or with your DVD posted to:

Racism. No way! Competitions
Locked Bag 53
Darlinghurst NSW 2010

Entry Category: Tick one
12 years or under  13 years or over
Name of Entry: 
Entry video file:
Individual or Team Representative (no more than 5 members in a team)

 First Name  Family Name :
Date of Birth: Age: Gender:
Day:  Month:  Year:   Male:    Female:

 First Name :  Family Name :
Date of Birth: Age: Gender:
Day:  Month:  Year:   Male:    Female:

 First Name :  Family Name :
Date of Birth: Age: Gender:
Day:  Month:  Year:   Male:    Female:

 First Name :  Family Name :
Date of Birth: Age: Gender:
Day:  Month:  Year:   Male:    Female:

 First Name :  Family Name :
Date of Birth: Age: Gender:
Day:  Month:  Year:   Male:    Female:

School Details

 School name
 Street Name and Number: 
Suburb or Town:  State

Teacher
I certify that the video submitted is the work of the student/s above
Name 

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NSW Department of Education and Training

Racism, No way! is an Australian anti-racism education initiative managed by the Department of Education and Training on behalf of education systems nationally.

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