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Short Course Enrolment Form

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Short Course Enrolment Form

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									                                                                                                                                                                                                            Short Course Enrolment Form
Name of Short Course................................................................................................................................................                                        shortcourses.endeavour.edu.au • ENROL NOW
Start Date of Short Course ..........................................................................................................................................

PERSONaL DEtaiLS
title ................ First Name .............................................................................................................................................

Middle Name ....................................................................... Surname ........................................................................

address...........................................................................................................................................................................

State ......................Postcode ......................Date of Birth ..........................................................................................

PayMENt OPtiONS
total amount $ .............................................

Payment by:                           Cheque/Money Order                                      Visa                            Mastercard                         Bankcard                    Cancellation Policy - Please Read
                                                                                                                                                                                             Cancellation fees are applicable to        If a student cancels on or after official
Card Number                                                                                                                                      Expiry Date
                                                                                                                                                                                             students who withdraw from the short       start date of short course/workshop they
                                                                                                                                                                                             course program.                            shall receive no refund or no credit
                                                                                                                                                                                                                                        transfer.
                                                                                                                                                                                             Cancellation Fees:
Cardholder’s Name ......................................................................................................................................................                     20% cancellation fee applies - From        Please be aware - students who
                                                                                                                                                                                             the time that the enrolment is processed   do not attend, cannot transfer into
Signature .......................................................................................................................................................................            until the official start date of short     another course date.
                                                                                                                                                                                             course/workshop
Gender:                 Male                    Female
                                                                                                                                                                                             OFFICE USE ONLY
Phone: aH ........................................ BH: .............................................. Mobile: ......................................................
                                                                                                                                                                                             Date Processed:
Email ........................................................................................................................................                                               Receipt No:
                                                                                                                                                                                             Student Number:
May we contact you regarding your studies via email?                                                              yes                        No
                                                                                                                                                                                             Amount Paid: $
i have read and understood the cancellation policy                                                               yes                                                                         Entered by:

How did you hear about us?                                Expo               Enrolment adviser                          Website                  Google Search                       Other   Cash             Cheque           Credit Card       EFTPOS

								
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