REGISTRATION FORM
North Keppel Immersion Weekend 15 -16 October
Name: ------------------------------------------------ --------------------------
Email Address: ------------------------------------ --------------------------
Phone Number: ----------------------------------- -------------------------
Next of Kin: -------------------------------------- Phone -------------------
Signature: ---------------------------------------------------------------------------
The cost is $155, payable in full on or before 5 October.
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Account details for a bank transfer are:
AF de Rockhampton
Commonwealth Trading Bank BSB: 064-709
A/C No: 10257936
Please be sure to put your name on the transfer.
Cheques made out to AF de Rockhampton need to reach Nola
by 5 October.
Alliance Française de Rockhampton
PO Box 3413
RED HILL POST OFFICE
NORTH ROCKHAMPTON QLD 4701
Cash/cheque payments may be made at class.
WHAT TO BRING
Medical certificate (Attached) This must be handed in to
Island Staff in Arrival.
Items on list supplied by North Keppel (Attached)
writing materials
French dictionary
comfortable clothing for yoga and jogging
wine/ something to drink