DANTE ALIGHIERI SOCIETY

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					          DANTE ALIGHIERI SOCIETY
                       Suite 15, Level 1, 104 Bathurst St, Sydney 2000
                                 Tel 92830261 Fax 92830263
                              enquiries@dantealighieri.com.au
                                 www.dantealighieri.com.au

                                 ENROLMENT FORM
I wish to apply for enrolment in Class: ……………………………………………………....

Day……… …………………………Time …………………am/pm

Please tell us which other days you would be available…………………………………..

Title/Mr/Mrs/Ms: ……………………………………………………...…………………….
Address: ……..……………………………………………………………………………….

Suburb: ………………………………………………..                             Post code: ………………………
Tel (H): ………………………………….                      (W): …………………………………………
(M): ……………………………..email: …………………………………………………....

Where did you hear about us?
Internet □   Newspaper □             Other □ (Specify)…………………………………….

PAYMENT OF FEES
Course: $250 Society Membership: $10 (yearly subscription)
Payment may be made in cash, money-order or cheque made payable to:
Dante Alighieri Society Inc, and mailed to the above address.

5% Discount for enrolments of 2 terms (when paid simultaneously)
10% Discount for enrolments of 3 terms (when paid simultaneously)
Credit card payments will incur a surcharge of 4%

                              CONDITIONS OF ENROLMENT
Tuition fees are payable in advance and cannot be refunded under any circumstance.
The Society reserves the right to cancel or restructure any class if a minimum of enrolments is
not obtained. Fees will be returned in case of cancellation.

I understand and accept the conditions of enrolment.

Signature of Applicant……………………………………..

Date…………………………..

				
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Description: DANTE ALIGHIERI SOCIETY