Apply to host Messenger Dogs – Tales of WWI Group * School Community Group School or Community Group name * Address * Suburb * Postcode * Contact Details Title First Name * Surname * Position * Phone Number * Email * Requested Performance Date (Monday – Friday only) Please note, your requested performance date is based on availability. Availability will be confirmed within 7 working days of our team receiving your booking request. Day * Unknown 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month * January February March April May June July August September October November December Year * 2016 2017 Preferred performance time * 9 10 11 12 1 2 3 4 5 6 7 8 : 00 15 30 45 AM PM Would you like to request a second performance on the same day? * Yes No Preferred second performance time * 9 10 11 12 1 2 3 4 5 6 7 8 : 00 15 30 45 AM PM Would you like to request a third performance on the same day? * Yes No Preferred third performance time * 9 10 11 12 1 2 3 4 5 6 7 8 : 00 15 30 45 AM PM Estimated attendance at the event (note minimum 40 and maximum 100 per performance) * What age range or grades will be attending the performance? Venue Details Proposed venue and address * Performance Space Type (note a flat surface is preferred due to the interactive components of the performance) * Classroom Hall Gymnasium Library Community Centre Other (please specify - if a seated theatre is the only option available provide details here) Capacity of the room for the event * Other performance requirements Close to vehicle access Table and chairs available Access to power 40 minutes available either side for set-up/down A member of Messenger Dogs - Tales of WWI will contact you shortly to discuss your expression of interest. Whilst every endeavour will be made to accommodate your expression of interest, the Department of Premier and Cabinet (DPC) reserves the right to accept or decline any expression of interest and the decision will be final. By submitting your expression of interest you agree to accept the decision of DPC as final and understand that DPC reserves the right to decline any expression of interest. Cancellation Policy - Three weeks notice must be provided for any cancellations or change of dates. PRIVACY: DPC and our service providers value the privacy of every individual’s personal information. We are committed to maintaining the privacy of personal information and will adhere to the Privacy and Data Protection Act 2014 (Vic). Attendees at this event may be photographed or video recorded at the event for promotional purposes. These images may be used in Victorian Government publications and websites, media coverage and other communications. For more information about how DPC protects privacy and personal information, please refer to our privacy statement If you would like this form in an alternative format, or require any further information, please telephone DPC on 03 9651 2023 or 03 9651 2113 or email firstname.lastname@example.org.