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Courses for Adults Enrolment Form

1. Select a course
Tuition Year:*
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Course*
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Select Term:*
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Starting Date :
Please select year, course and term.

2. Student Details
First Name:*
Please enter your first name.

Last Name:*
Please enter your last name.

Street Address:*
Please enter your address.

Suburb/Town:*
Please enter your suburb.

Postcode:*
Please enter your postcode.

Phone:*
Please enter your phone number.

Your Email:*
Please enter your email address.

3. Emergency Contact
Name:*
Please enter the name of your emergency contact.

Phone Number:*
Please enter the number of your emergency contact.

Relationship:*
Please enter the relationship you have with your emergency contact.

4. Fees Details
Selected Course :
Please select year, course and term.

Tuition Amount:
Please select year, course and term.

Book :
Please select year, course and term.

Book Option:
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Companion/Work book :
Please select year, course and term.

Companion/Work book Option:
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Postage Option:
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Total Amount: $
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5. Payment Details
Name on Card:*
Please confirm your Credit Card Details.

Cardholder Address:*
Please confirm your Credit Card Details.

Card Number:*
Please confirm your Credit Card Details.

Visa or MasterCard

Card Expiry (mm/yy):*
Please confirm your Credit Card Details.

Card CVC:*
Please confirm your Credit Card Details.

6. Submission
How did you hear about us?:
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Why did you choose our School?
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Why do you want to learn Greek?
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(check all that apply)

Other reasons not covered above:
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Comments relating to the sign-up process:
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If you have any comments relating to how easy or hard it was find us, the information we provide relating to the chosen class, or the sign-up process, or anything else please enter them here.

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