STAFFORD HEIGHTS STATE SCHOOL COMMUNITY EDUCATION

                                   Enrolment Form

After contacting the appropriate phone lady please send completed form with Cheque, Money Order or Credit Card Details to:-

                Stafford Heights State School P&C

                                PO Box 1122

                                Stafford City    Q4053

Name:- _____________________________________________________________

Address:-____________________________________________________________

 ____________________________________________________________________

 Phone:- ______________________ (Home)__________________________(Mobile)

Email Address (for email list):-______________________________________________

Course:-______________________________________________________________

Day:-__________________________Time:-_________________________________

                    For Credit Card Holders Only:-

Credit Card Number:-___________    __________   __________   __________

 Card Expiry Date:-_______  /  _______        Mastercard ____ Visa____

 Name Printed on Card:-___________________________________________________

 I hereby authorise the Stafford Heights State School P&C- Community Education to debit my credit

 card account, the amount of $.....................  Signature:-...............................................

IMPORTANT:-Your enrolment is not final until form and full fees have been received.

Please ensure you contact the appropriate phone lady before sending in enrolment form

You will be advised if a class you have booked into is cancelled.

Receipts will usually be issued at the second class - no further advices will be forwarded.