School / Early Learning Centre Registration form YES! We are going purple for Purple Day! Here is what we will be doing to show our support. Please check the activities you are planning to do. In some instances a member of our team may need to contact you for further information. School / ELC Registration Form If you are a human and are seeing this field, please leave it blank. First Name Last Name School / Early Learning Centre Address Suburb Post Code Email Phone We are going purple for Purple Day! Here is what we will be doing to show our support Hold a purple dress day and donate any proceedings to Epilepsy Association ACTHost our own Purple Day fundraising activity and/or an event and donate proceedings to Epilepsy Association ACTInvolve staff and children in purple activities to raise epilepsy awarenessWe will be using the free resource packs available from your webpageBuy Purple Day merchandise. Please email me an order formSell Purple Day Merchandise on behalf of the Epilepsy Association ACT. Please email me an order formPlease send us a plush toy raffle to draw at our school or Early Learning CentrePlease send us a purple day posterWe would like to submit Purple Day photo/s and give permission they be used for promotional purposes I wish to register a Early Learning CentrePrimary SchoolHigh School CollegeOther We have a connection with epilepsy (please specify) (optional) Thank you for supporting the Epilepsy Association ACT and bringing epilepsy out of the shadows. Together we are breaking down barriers, spreading awareness and helping people with epilepsy.