School Name:

Are You Currently In The Chance to shine Programme?  Please select Yes No

C2S Club:

Other User (CDM / PDM):

County:

Head Teacher:

Key Contact (put "as above" if Head Teacher):

School Address:

Postcode:

Telephone Number (Key Contact):

E-mail Address (Key Contact):

We will take part in the Chance to shine cricket day on Tuesday 20th May, 2008:

Please select Yes No

Another Day? (Please specify date)

Can you briefly describe what activities will be undertaken (cricket & cross-curricular) & the support you would like to receive?