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COURSE |
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DATE |
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NAME |
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ADDRESS (WORK): |
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ADDRESS (HOME): |
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TELEPHONE(HOME): |
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TELEPHONE(WORK): |
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OCCUPATION: |
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CONTACT PERSON: |
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TELEPHONE (HOME): |
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TELEPHONE
(WORK): |
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NEXT OF KIN: |
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ADDRESS: |
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TELEPHONE: |
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SIGNED; |
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FOR OFFICE USE ONLY
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COURSE; |
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REGISTRATION FEE: |
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PAYMENTS MADE: |
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To register for course at the Philip Sherlock Centre,
print this docuument, complete and submit this form to the office
with a registration fee of $150 along with the payment for the desired
course. Sorry, we do not accept credit cards.
home| courses
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