Application Form
ADDRESS: _________________________________________________
POSTAL CODE: _______________TELEPHONE: ________________
Please enroll me in the auction course commencing _______________________________________________20__________
To be held in
I enclose herein my deposit of $150.00 (one hundred and fifty dollars) and agree to pay the balance upon arrival at the first class.
Is a room required: ___YES ___ NO / SINGLE____ DOUBLE____
I will be paying deposit by ___Check ___ Money Order ___ Credit Card
Credit Card ___ M/C ___ Visa ___ AMEX
Card Number: ________________________________
Expiry Date: _________________________________
Name on Card: ________________________________________________
DATED AT: _________________ THIS______
STUDENT SIGNATURE_________________________________________________