Enrolment Application Form

U3A Okeover Term 4, 2024 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 if he is available.

Your Name(s):

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

Enter member name(s):

Member 1

Member 2

Select Your Courses...

The cost is $20.00 per course.

A: Thursdays 31 Oct 2024 to 28 Nov 2024

A: November Series

Additional Items

Luncheon

After the presentation at Chapel St. Centre the luncheon will be at Hornby Club, 17 Carmen Road, Hornby on Thursday, 28th November. Please arrive after 12 noon. Main course will be served at 12.45. The menu is catering for people's dietary needs. Non-member guests will be charged $45. Please register them with the treasurer.

Luncheon ($35.00 )

Note any special dietary needs here:

Payment

Total Due

__________

Payment Method

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

Questions/Comments:

Your Contact Details

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:

Lifelong Learning

Course enrolment