Enrolment Application Form

U3A Okeover Term 3, 2023 Courses

You can either:

fill in the form below and click the "Send Enrolment Application" button to submit your enrolment to us online, or
print the form, fill it out on paper, and hand your enrolment form to the treasurer at the desk.

Please hand your enrolment form to the treasurer at the desk.

You can use this form to enrol one or two members.

Enter member name(s):

Member 1

Member 2

The cost is $20.00 per course.

A: Advancing Science

Followed by...

B: Economic Issues

Total Due

__________

Payment Method

Via Internet or Phone banking into account No 03-1594-0108506-00 (Please ensure you enter a surname and initial)

Please provide your contact details, so that we can contact you in relation to this enrolment application:

Name:

Email:

Complete these details only if they have changed:

Address:

Post Code:

Phone:

Emergency Contact:

Emergency Phone:

Signature: