Your Name (required)

Position (required)

School (required)

School Address (required)

Your Email (required)

Item(s) requested. Please list in descending priority order, with cost of each.

Total cost (GST exclusive)

Please attach quotations for the items you are requesting

Previous Chemical Education Trust funding (last three years)

Please explain how the funding will improve the quality of the chemistry teaching in your school (e.g., what will it be used for, how many students will benefit, what level are their classes, etc.)

Please attach a signed supporting statement from your principal or HOD

School bank account number (required)

Please attach a copy of the deposit slip