QEII Hospital name the crane entry form

The crane’s name is *

Why is this a great name? *

I'm entering as a *

Primary or high school studentPrimary or high school classFamily or individualStaff member or volunteer

Student’s name *

Student’s school *

Student’s school year *

Parent or guardian’s name *

Parent or guardian’s phone number: *

I consent to my child’s first name and school year being used on the hospital’s social media and website for the purposes of promoting the ‘Name the Cranes’ competition. *

Class or grade *

School *

Teacher’s name *

Teacher’s phone number *

I consent to my class and school being used on the hospital’s social media and website for the purposes of promoting the ‘Name the Cranes’ competition. *

Family or individual’s name *

Your suburb *

Best phone number *

Are you a *

PatientVisitorLocal residentOther

Please enter

I consent to my first name or family name being used on the hospital’s social media and website for the purposes of promoting the ‘Name the Cranes’ competition. *

Name *

Position *

Department *

Email *

Phone number *

I consent to my first name or family name being used on the hospital’s social media and website for the purposes of promoting the ‘Name the Cranes’ competition. *

After entries close, we will post the shortlisted names for each crane on our Facebook page for your votes.