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Generation SunSmart
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Registration Form
User name
Enter a user name, usually something like 'jsmith'. No spaces or special characters. User names and passwords are case sensitive, make sure the capslock key is not enabled. This is the name used to log in.
First name
(Required)
Enter your first name here.
Last name
(Required)
Enter your last name here.
Phone Number
Please enter your daytime telephone number in the format: (AREA CODE) PHONE NUMBER
E-mail
(Required)
Enter an email address. This is necessary in case the password is lost. We respect your privacy, your email address will only be used for purposes relatingto communication and evaluation of this workshop.
Postal Address
Please list your postal address below.
This address will be used for any written correspondence to participants.
City
State
(Required)
<select>
Western Australia
Australian Capital Territory
Queensland
New South Wales
Northern Territory
South Australia
Tasmania
Victoria
Outside Australia
Country
(Required)
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Ascension Island
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo (DRC)
Congo
Cook Islands
Costa Rica
Côte dIvoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Islas Malvinas)
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia, The
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jordan
Jersey
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands Antilles
Netherlands, The
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Authority
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Samoa
San Marino
São Tomé and Príncipe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Kitts and Nevis
St. Lucia
St. Pierre and Miquelon
St. Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands
Virgin Islands, British
Wallis and Futuna
Yemen
Zambia
Zimbabwe
Postcode
Please check this box if you are in the Metropolitan Area of your capital city.
Current Position
(Required)
Please choose from the list below
<select>
Teacher
School Health Nurse
Principal
Deputy Principal
Child Care Worker
Other (please specify below)
Current Position (if not specified above)
Please provide a brief description of your current position.
What year level(s) do you teach?
Please choose from the list below
Child Care
Kindergarten
Pre-primary
Yr 1
Yr 2
Yr 3
Yr 4
Yr 5
Yr 6
Yr 7
Yr 8
Yr 9
Yr 10
Yr 11
Yr 12
Name of School or Child Care Centre (if you are currently teaching)
Please list your school or centre below
Have you taught sun protection before?
(Required)
Please choose from the list below
<select>
Yes
No
How did you find out about the Generation SunSmart website?
Please choose from the list below
<select>
Referral From a Friend or Colleague
Advertisement
Internet Search
The Cancer Council Website
Email
School Newsletter
Other (please specify below)
How did you find out about the Generation SunSmart website? (if not specified above)
Reason for accessing this professional development website
Please let us know your reason for accessing this professional development website. If you have any comments for us or need to tell us anything, please feel free to let us know here.
Which resource would you like to receive?
Please choose from the list below
Be SunSmart, Play SunSmart (Child Care resource)
Kidskin Yr 1
Kidskin Yr 2
Kidskin Yr 4
Kidskin Yr 6/7
Tattoo Secondary Resource (Yr 8-12)
Real Stories DVD Package (Yr 8-12)
Is this the first time you have registered to the Generation SunSmart web site?
(Required)
Yes
No
If No, what is the reason for registering again?
<select>
New modules
New teaching resources
Forgot login details
Other... (Please specify below)
Reason for registering again (other)
I would like to be sent information about Generation SunSmart and the new modules as they become available
The Cancer Council WA is committed to respecting the rights of individuals including their expectations of privacy, and fully supports the principles contained within the legislative privacy guidelines. The information you have provided will not be passed on to a third party and will only be used for contacting you in relation to the Generation SunSmart website and resources available.
Password
Minimum 5 characters
Confirm password
Re-enter the password. Make sure the passwords are identical.
Send a mail with the password