Enrolment Form

Please refer to course information on this page, and contact us if you wish to enrol.

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Given Name(*)

Please let us know your name.

Surname(*)

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Postal Address(*)

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Town(*)

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Postcode(*)

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Phone(*)

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Secondary Phone

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Your Email(*)

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New or Continuing(*)

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Class Selected(*)

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'Early Bird' Fees(*)

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Term 2 Courses: Pay by Sunday, 28th April 2024

AFCDN student membership(*)

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AFCDN Membership is compulsory for all students and needs to be renewed annually (in January). If you were enrolled in a Term One 2024 class, your membership is still current.

Alter Ego Plus books(*)

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Total $(*)

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Payment Method(*)

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Direct Deposit
NAB - Molesworth St, Lismore
Acc Name: Alliance Française Côte du Nord Inc
BSB: 082-707
Acc No: 712939366 (NB: Our account number has recently changed)
* Remember to include your name & a description of your payment
or
Cheque - payable to "Alliance Française Côte du Nord Inc"
PO Box 6061, South Lismore NSW 2480

Terms & Conditions(*)

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I have read the terms and conditions

How did you hear about this class?(*)

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Photo Permission(*)

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I give permission for photos of myself
to appear on the website

Questions or Comments

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Alliance Française Côte du Nord (NSW North Coast)

Enrolment Form

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