WTC Course Registration Form CC

Student Name

First NameMiddle NameLast Name

Birth Date

MonthDayYear

Gender

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student E-mail

example@example.com

Mobile Number

Phone Number

Area CodePhone Number

Work Number

Current Work Place / Role

Where did you hear about us?

If you were specifically referred to the program by an individual, either in discussion or via their social media/ community promotions - please add their name

Is there anything else you need to tell us about?

My Products

Auslan (Adult) Level 1Level 1 Basic Tuesdays from 21st February, 6pm -7.30pm for 5 weeks. Fingerspelling Basic Words and Topics Great for a beginner. Loads of fun!!

$199.00AUD

Meditation for Kids5 session program designed specifically for children, to support with relaxation, emotional regulation, sleep and development. Runs 20 Feb-27 March (PH break 6 March)

$49.00AUD

Class Group (Age, Time)	Number of Children Enrolling (discounts apply)	Price
4-6 years: Monday 3.30-4pm		$49.00AUD
7-9 years: Monday 4-4.30pm		$49.00AUD
10-12 years: Monday 4.30-5pm		$49.00AUD

Total

$0.00AUD

Payment Methods

Debit or Credit Card

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

Student Registration & Payment Form