NAENAE COLLEGE COMMUNITY EDUCATION PROGRAMME
ENROLMENT FORM

Surname:_______________________________________________________

First name:______________________________________________________

Home Address:___________________________________________________

Phone (Home) :_______________________ Bus: ________________________

Course:__________________________________________________________

Night:___________________________________________________________

Fee enclosed (cash/cheque) : $_________________

For Ministry of Education Statistical Purposes only
(Please Circle)

Gender:  Male /  Female

Age: 16-19   20-29   30-39   40-49   50-59   60+

Ethnicity: NZ European (Pakeha)  /  European  /  Maori  /  Pacific Islander  /  Asian

Other: _______________________________

 

Please post this form along with your payment to: Community Education Programme, Naenae College, Private Box 31-171, Lower Hutt.


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