Enrolment – JDW

Student Name*

Gender

Age

Date of birth

Occupation

Home

Mobile*

Email*

Address

Suburb

Postcode

Address

Parent/Guardian Name: (if under 18)

Parent/Guardian Signature: (if under 18)

Course*

Course Date*

Payment Method*

Visa
Mastercard
Bank Transfer

CREDIT CARD

BANK TRANSFER

Account Name: Chic Management
Brisbane Pty Ltd

BSB: 032 102
Account: 136 685
Description: First Initial, Last name, Course

Please note: Required deposit amount or full payment must accompany this enrolment form.
The deposit will under no circumstances be refunded however; two lessons may be attended in another programme. Should an enrolled student be unable to commence, the enrolment will roll over to another programme.
There is a no refund policy.

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