Non Accredited Training Enrolment Form

Thank you for your interest in Network's training. Please complete all fields below and the course fee on the next page. If you have more than 3 Educators wishing to attend please contact us 9212 3244 or via email learning@networkofcommunityactivities.org.au. For our full terms and conditions please visit our website. 
First Name
Entity Data - Profile - First Name
Surname
Entity Data - Profile - Surname
Gender
Entity Data - Profile - Gender
Birth Date
Entity Data - Profile - Birth Date
Personal - E-mail Address (Do not use a service email)
Entity Data - Contact - Home - E-mail Address
Personal - Mobile Number (Do not use service number)
Entity Data - Contact - Home - Mobile Number
Service Name
Basic - Text
Are you a network member?
Basic - Dropdown
What is your Network Membership Number?
Basic - Text
Conditions and Consent:
Basic - Checkboxes
Digital Signature
Basic - Digital Signature
Date
Basic - Date

Payment

Full payment is due before registration is confirmed. Please note, cost of course may be tax refundable - seek advice from your tax advisor.
Payment Options
Network Member ($65 + GST Network Members) 		$65.00
Non Member - Student or Employer ($110 + GST Network Non Members) 		$110.00
$65.00
$6.50
$71.50