UQL CYBERSCHOOL MEMBERSHIP APPLICATION

Name of School	^*
Contact Person (in school library)	^*
Contact's Position / Title	^*
Contact's Subject Area (if not obvious from position/title)
Contact's Year Level Responsibilities
Address line 1	^*
Address line 2	^*
Address line 3
Postcode	^*
Phone	^*
Fax	^*
Email (for contact person)	^*
Person submitting form (if different from Contact)
Submitter's Position / Title
Technical Support Person in school (for contacting)
Email for Technical Support Person
I confirm that the information above is true and complete. ^* I have read and accepted the University of Queensland Privacy Statement. ^* ^* indicates mandatory field.
Your email address will be added to the UQL Cyberschool Discussion List.

	©2008 The University of Queensland, Brisbane Australia
	ABN 63 942 912 684
	CRICOS Provider Number: 00025B
	Authorised by: University Librarian
	Maintained by: UQ Library
	Last Updated: 6 June 2008.