DHS Country Week School Information Form "*" indicates required fields School InformationFull School Name* Principal's Name* HOLA's Name* Country Week Coordinator's Name* Mobile Number* Country Week Coordinator - number of years attending Country week [including this year]* Total number of students attending Country Week* Total number of staff attending Country Week* Perth Team AccommodationResidence in Perth* Address* Phone Number* Coach and Manager DetailsIndicate the teams you have nominated and complete the Coach/Manager details* Badminton Basketball Boys Team 1 Basketball Boys Team 2 Basketball Mixed Hockey Mixed Netball Team 1 Netball Team 2 Netball Team 3 Futsal Mixed Volleyball Mixed Name - Badminton Coach* First Last Mobile Number* Number of years attending Country Week?* Name - Basketball Boys Team 1 Coach* First Last Mobile Number* Number of years attending Country Week?* Name - Basketball Boys Team 2 Coach* First Last Mobile Number* Number of years attending Country Week?* Name - Basketball Mixed Coach* First Last Mobile Number* Number of years attending Country Week?* Name - Hockey Coach* First Last Mobile Number* Number of years attending Country Week?* Name - Netball Team 1 Coach* First Last Mobile Number* Number of years attending Country Week?* Name - Netball Team 2 Coach* First Last Mobile Number* Number of years attending Country Week?* Name - Netball Team 3 Coach* First Last Mobile Number* Number of years attending Country Week?* Name - Futsal Coach* First Last Mobile Number* Number of years attending Country Week?* Name - Volleyball Coach* First Last Mobile Number* Number of years attending Country Week?* Other InformationEducation Region*South MetroNorth MetroGoldfieldsKimberleyMidwestPilbaraSouth WestWheatbeltUnknownEducation Sector* Department of Education AISWA CEWA School Type* Government Non-Government GenderNumber of students if known.Male*Female*Gender DiverseEthnicityNumber of students if known.Aboriginal and/or Torres Strait Islander*Cultural and/or Linguistic Diversity (CaLD)*Includes students who speak another language at home; where English is their second language; whose parents were born overseas.DisabilityStudents With A DisabilityIf known this includes students with a diagnosed physical, intellectual, sensory or social & emotional disability.School CaptainsBoyGirl Add RemovePlease provide 2 Captains NamesCommentsThis field is for validation purposes and should be left unchanged.
