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Please fill in the required fields below
Young Environmentalist Awards Registration Form
School / Youth Group Name:
School / Youth Group Address:
Name of Teacher / Youth Leader:
Number in Group:	2-5 6-10 11-15 16-20 21-25 >25
Names of Group Members:
Age Category:	Junior ( 12-15 yrs) Senior ( 16-18 yrs)
Telephone - School / Youth Group:
Mobile - Teacher / Youth Leader:
Email Address:
Project Category:	Biodiversity Climate Change Consumerism ECO Art and Design ECO Community Development ECO Enterprise ECO Heritage ECO Technology Energy Transport Waste Water
Please briefly outline your YEA project:
How did you hear about the YEA?
To your knowledge is this the first time your organisation is being involved in the YEA?
	Yes No
Would you like to receive information about YEA Teacher/Leader training sessions?
	Yes No
Would you be interested in affiliating your group with the ECO-UNESCO Clubs Programme?
	Yes No
Would you like to receive the ECO-UNESCO monthly E-Bulletin & additional emails about all of our exciting events and workshops?
	Yes No