VIC Registration Form

The Asthma Foundations of Australia invite your school to Register your interest in the Asthma Friendly Schools (AFS) program. By completing the online form below you will receive a Principal Pack, including national program guidelines and curriculum resources. These will enable your school to achieve the essential criteria to gain Recognition as an Asthma Friendly school.

NEXT STEPS: To become an Asthma Friendly School, please refer to the AFS guidelines here, and work with the Asthma Foundation VIC to address the AFS program's 8 essential criteria. Complete the online AFS Recognition Checklist form to provide evidence when all 8 essential criteria have been achieved.

# Required Fields
School
School: #
Campus (if applicable):
Address: #
Address Line 2:
City: #
State: #
Postcode: #
Contact Details: Phone: #
Fax:
Email: #
Website:
Principal: #

Key Contact Person
Contact Name: #
Position:
Contact Details Email: #
Preferred Contact Method:
Times:

School Details
Government
Catholic
Independent Other

Primary
Secondary
Combined Other
Specialisation (if any):
Year Levels Range:
Number of Staff: #
Local Council / Shire:

Number Of Students
Total: #
Students with asthma*:
CALD Students:
CALD Students with asthma*:
Indigenous students:
Indigenous Students with asthma*:
* (Please estimate if actual numbers unknown)
CALD stands for students from Culturally And Linguistically Diverse backgrounds.

Person completing form:
Position:

PRIVACY: Information provided will be used by the Asthma Foundation in the management of the AFS program only. All information will be treated as confidential and will not be supplied to any other party for any other purpose.



Asthma Friendly is a registered trademark of the Asthma Foundations of Australia.