ILCNSW Home Mods Personal details Question Title * 1. Which course dates are you interested in attending? 17th - 18th March 2016 (ILC NSW Blacktown) 12th - 13th May 2016 (Canberra) 25th - 26th August 2016 (Tamworth) 20th - 21st October 2016 (ILC NSW Blacktown) None of the above, but interested in future courses Location you would be interested in: Question Title * 2. Enter your full name Family name (surname) Given names Question Title * 3. Sex (Tick ONE box only) Male Female Question Title * 4. Where do you live? Suburb, locality or town State/territory Postcode Question Title * 5. What is your occupation? Question Title * 6. What are your contact details? Phone Mobile Fax Email Question Title * 7. Where did you hear about the Home Modifications Course? Question Title * 8. General comments / additional info: Question Title * 9. Would you like to receive ILC NSW training mailouts for upcoming courses (via email)? Yes, add me to your mailout list. No, I am not interested. Your next steps are: 1. To read the training guide: Training Guide 2. Fill in the enrolment form: Enrolment Form Please send your enrolment form either by: 1.Fax: 02 8814 9656 2.Email: welcome@ilcnsw.asn.au Done
