Sign Up - Flourishing At School

School Name*

School Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Postal address (if different to the School Address)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

School ABN (leave blank if not from Australia)

Number of Students (Secondary Only)*

Staff are now serviced by the FlourishDx product (www.flourishdx.com). Please visit the website for details and to sign up.

Contact Name*

Prefix First Last

International Prefix (Phone)*

Contact Phone*

Contact Email*

Enter Email Confirm Email

Do you want to create Form or House Groups for Identification in the data later?

Would you like to use Form Groups or House Groups?

Please list all of the form or house groups in the box below with each entry on a new line

Example
9A
9B
10C

How would you prefer to pay?*

Promotional Code

Privacy Policy, Terms of Service & End User License Agreement

Please read our Privacy Policy, our Terms of Service, and our End User License Agreement before submitting your application.

I have read and agree to the Privacy Policy, Terms of Service and the End User License Agreement.*

CAPTCHA

School Signup Form