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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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