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THE PHILIP SHERLOCK CENTRE FOR THE CREATIVE ARTS REGISTRATION FORM COURSE
COURSE: __________________________________________________
DATE _________TO__________ OR SUMMER ___________________
NAME: ___________________ ______________________ MR/MRS/MISS SURNAME OTHER
ADDRESS(HOME): ______________________________________________________ (WORK): __________________________________________________
TELEPHONE:(HOME) ___________________________________________________ (WORK)_______________________________________________________ OCCUPATION:
CONTACT PERSON:_______________________________________________________
TELEPHONE(HOME)__________________ (WORK)______________________________
NEXT OF KIN: ____________________________________________________ ADDRESSS: ____________________________________________ TELEPHONE: ___________________________________________ SIGNED: _____________________________________________ -------------------
-------------------------------------------------- FOR OFFICE USE ONLY COST OF COURSE:_______
REGISTRATION FEE:________________ PAYMENTS MADE:_______________________________
To register for courses offered by the PSCCA, complete and submit to the office with aregistration fee of $150. Sorry we do not accept credit cards.