If you're keen to take the challenge, complete the form below. A letter will be sent to you and your principal about the challenge, and what to do next.

First name:
Surname:
School:
School Address:
School suburb:
School postcode:	School state:    NSW VIC SA QLD WA TAS NT ACT
Region:	Central Coast Greater Western Sydney Hunter Murray-Riverina Northern NSW Southern NSW Sydney Metropolitan Western NSW
School telephone number:
Principal or teacher's name:
Your email address:
What year are you in?	6 & below 7 8 9 10 11 12 other
Where did you hear about the Youth Challenge?
Television:
Newspaper:
Other:	please specify:
Why do you want to take the challenge?