Each
person is required to attend in a separate car to
ensure you receive the full benefit from the time allocated to you in each
exercise. Your booking may be secured by sending/faxing this enrolment form and
payment for the full amount of the course fee: $295.00 inc.
Refunds are not available but you may transfer to another course with one week's
notice. Full payment must accompany application forms and you may pay by cash,
cheque or any of the credit cards listed below.
We will confirm your booking for the course day selected after payment received. Please enrol the following person in the Car Control Course:
Date of course
required: ..........................................................
(Roadcraft courses must be booked by telephone for a mutually convenient date)
Name: ........................................................................................
Address: .....................................................................................
.......................................................Post Code ...........................
Phone: (.......)............................... Mobile ....................... Email ........................
On "P" plates?...........
Car make and
model: ..................................................................
TAX INVOICE (ABN 99 293 740 948)
I enclose cheque/money order for $...........................
I authorise you to debit my account with the following amount
$......................
YOUR NAME ON CARD ...........................................................
Card No. __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
EXPIRY DATE
....../......./....... AMOUNT ................. CARDHOLDER’S SIGNATURE
..........................................
TICK CARD:
American Express‚ Bankcard‚ Mastercard‚ VISA
To
pay by direct bank debit, send monies as detailed below and put the receipt
number on enrolment form:
Account Name: PJ & GD Finlay
Bank: Westpac
Branch: Pennant Hills
BSB: 032 377
Account number: 680 444
Peter Finlay’s
NATIONWIDE DEFENSIVE DRIVING SCHOOL
RTA instructors licence 0005666
40 Northam Drive North Rocks NSW 2151 Australia
Tel: (02) 9873 1773 Fax: (02) 9871 1018 e-mail: peter@finlays.com.au
OFFICE USE ONLY (Form 1/6/06):
CONFIRMED
.............................................................................
PAID ............................................GST :
....................................
COURSE COMPLETED ............................................................
GRADE
......................................................................................
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