S26 AMPOL LITTLE ORIGIN

2026 AMPOL LITTLE ORIGIN
Entrant Details
Entrant Name*

First NameLast Name
Entrant Email*
example@example.com
Entrant Mobile Phone Number*
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School Details
School Name*
School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Teacher Details
Teacher Name*

First NameLast Name
Teacher Email*
example@example.com
Teacher Mobile Phone Number
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Entry Details
Is your School able to field 10 male and female players from grade 5 & 6 (Ages 10-12)?*

YesNo
Favourite State of Origin team?*

Queensland MaroonsNew South Wales Blues
What would the Ampol Little Origin Experience mean to your school? *

Tell us in 100 words or less0/100
If your School was selected, how would you spend the Ampol $5000 grant? *

Tell us in 100 words or less0/100
My nominated school is located within 150km of the below cities:*

BrisbaneGold CoastMelbourneSydneyNewcastle
Have you signed up as an NRL School Ambassador for 2026?*

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2026 AMPOL LITTLE ORIGIN