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ILCNSW Home Mods
Personal details
*
1.
Which course dates are you interested in attending?
(Required.)
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:
*
2.
Enter your full name
(Required.)
Family name (surname)
Given names
*
3.
Sex (Tick ONE box only)
(Required.)
Male
Female
*
4.
Where do you live?
(Required.)
Suburb, locality or town
State/territory
Postcode
*
5.
What is your occupation?
(Required.)
*
6.
What are your contact details?
(Required.)
Phone
Mobile
Fax
Email
*
7.
Where did you hear about the Home Modifications Course?
(Required.)
8.
General comments / additional info:
*
9.
Would you like to receive ILC NSW training mailouts for upcoming courses (via email)?
(Required.)
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
