Enrolment Form - Wairarapa College Community Education

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Enrolment form
Please fill out all * required fields

Code No.	Class Name:	Cost: $
Code No.	Class Name:	Cost: $
Code No.	Class Name:	Cost: $
Code No.	Class Name:	Cost: $
Please make a note of the total cost. We will confirm the total amount outstanding in our confirmation email. Please confirm that you intend paying by Direct Credit Y N		Total: $


Last name:*
First names:*
Addresss:*
Home Phone No.
Work Phone No.
Email Address:*

Ethnic Group:*	Please choose from below Maori NZ European/Pakeha Asian Polynesian Other
Age Group:*
I wish to pay by Direct Credit	ANZ Bank Masterton No 01-0682-0200279-08 Please ensure that your name and the name of class enrolled in is included on banking ref.

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