AFM COURSE REGISTRATION


Please print out this form and complete  using BLOCK LETTERS and return with payment to: Australian Food Microbiology, PO Box 246, Round Corner, NSW, 2158.

Return two weeks prior to course start date. 

Personal Details

Mr / Mrs / Miss / Ms

First Name

Surname

Job Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Organisation:...........................................................................................................................

Address:..................................................................................................................................

...................................................................................     Post Code:   ...................................

Phone Number: ......................................  Fax Number:   .......................................................

Email Address:  .............................................................................

 Course (tick appropriate box)

Full Day Course

2 x ½ day course

3 x 3 hour Course

        Call or email for details

        Call or email for details

        Call or email for details

Payment Details

Course Cost:  $ ........................................

        I enclose a cheque made payable to: Australian Food Microbiology

Booking Conditions

Cancellations notified in writing not less than 7 days before commencement of training will receive a full refund.  Refunds will be made within 14 days.  Participants may be substituted with the permission and knowledge of Australian Food Microbiology.

Signature:                                                    Printed Name: