Enrolment Form

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Given Name(*)

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Postal Address(*)

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Town(*)

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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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Course Fees(*)

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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 or Two 2026 class, your membership will still be valid.

Student materials & texts(*)

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Total $(*)

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Total = Fees + printed class materials (if applicable) + membership (if applicable)

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
* 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

I confirm that I am 18 years or older.(*)

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If you are younger than 18 years of age and wish to learn French, we are happy to assist you with organising private tuition.

How did you hear about this class?(*)

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Photo Permission(*)

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to appear on the website

Questions or Comments

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