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Which activity are you registering for? *
First Name *
Last Name *
Phone *
Are you primarily a * Select Option ACT Corrections Staff Members Partner of a Staff Member Family of a Staff Member
What is your occupational group? * Select Option Custodial Operations Community Corrections Court Transport Unit Programs Sentence Administration Section Case Manager / Transitional Release Centre Corporate Services Maintenance / Stores Commissioners Officer Executive Support (Admin AMC) Executive Aboriginal Torres Strait Islander Services Training Bakery/Kitchen/Laundry/Horticulture Finance / Procurement Intel Sentence Admin Board Policy Detainee Services (Library, employment, etc) IT/Projects
What is your relationship to the staff member? * Select Option Child Mother Step Mother Father Step Father Sibling Grandparent Friend
What is the staff members name and work email address?
Gender * Select Option Female Male Other Prefer not to say
Postcode *
Are you registering any additional adults from your family/ inner circle? * Select Option No 1 2
Has this person previously been registered for an activity? Select Option Yes No
Gender of Adult 1 * Select Option Female Male Other Prefer not to say
Is Adult 1 primarily a? * Select Option ACT Corrections Staff Members Partner of a Staff Member Family of a Staff Member
What Adult 1's occupational group? * Select Option Custodial Operations Community Corrections Court Transport Unit Programs Sentence Administration Section Case Manager / Transitional Release Centre Corporate Services Maintenance / Stores Commissioners Officer Executive Support (Admin AMC) Executive Aboriginal Torres Strait Islander Services Training Bakery/Kitchen/Laundry/Horticulture Finance / Procurement Intel Sentence Admin Board Policy Detainee Services (Library, employment, etc) IT/Projects
What is the staff members relationship to Adult 1? * Select Option Partner Child Mother Step Mother Father Step Father Sibling Grandparent Friend
Has this person previously been registered for an activity? Select Option Yes No
Gender of Adult 2 * Select Option Female Male Other Prefer not to say
Is Adult 2 primarily a? * Select Option ACT Corrections Staff Members Partner of a Staff Member Family of a Staff Member
What Adult 2's occupational group? * Select Option Custodial Operations Community Corrections Court Transport Unit Programs Sentence Administration Section Case Manager / Transitional Release Centre Corporate Services Maintenance / Stores Commissioners Officer Executive Support (Admin AMC) Executive Aboriginal Torres Strait Islander Services Training Bakery/Kitchen/Laundry/Horticulture Finance / Procurement Intel Sentence Admin Board Policy Detainee Services (Library, employment, etc) IT/Projects
What is the staff members relationship to Adult 2? * Select Option Partner Child Mother Step Mother Father Step Father Sibling Grandparent Friend
Are you registering any children from your family/ inner circle? * Select Option No 1 2 3 4
What is the staff members relationship to Child 1? * Select Option Mother Step Mother Father Step Father Sibling Grandparent Friend
Date of Birth *
What is the staff members relationship to Child 2? * Select Option Mother Step Mother Father Step Father Sibling Grandparent Friend
Date of Birth *
What is the staff members relationship to Child 3? * Select Option Mother Step Mother Father Step Father Sibling Grandparent Friend
Date of Birth *
What is the staff members relationship to Child 4? * Select Option Mother Step Mother Father Step Father Sibling Grandparent Friend
Date of Birth *