Section 1: Applicant's Details

First Name:     Surname:
Address:     Suburb:   Postcode:
Telephone:     Mobile:
Email:     School:

Year Level: Year 11 in 2010 Year 11 studying 1 or more Year 12 subjects in 2010 Year 12 in 2010
 

Section 2: Please enrol me into the following programs. Cost per subject is $95 (GST INC.)

Accounting ($95)
Biology - Session 1 ($95) Biology - Session 2 ($95)
Chemistry - Session 1 ($95) Chemistry - Session 2 ($95)Chemistry - Session 3 ($95)
Physics - Session 1 ($95)Physics - Session 2 ($95)
Psychology - Session 1 ($95)Psychology - Session 2 ($95)

Each session offers over 6.5 hours of instruction per subject. Please note that Sessions 1, 2 (and 3) of a particular subject are identical. Please choose 1 session per subject only.

Physics Applicants - Please Tick Your Chosen Detailed Study:

Structures and Materials ($0)Einstein's Relativity ($0)Further Electronics ($0)

Please enrol me into "Mastering the Exams." This lecture is FREE OF CHARGE to all students.

First Preference:Please select ONE of the following sessions (sessions are identical):Mastering the Exams - Sun 2 May 2010 ($0) Mastering the Exams - Sat 8 May 2010 ($0)Mastering the Exams - Sat 29 May 2010 ($0)

Second Preference:Please select ONE of the following sessions (sessions are identical):Mastering the Exams - Sun 2 May 2010 ($0) Mastering the Exams - Sat 8 May 2010 ($0)Mastering the Exams - Sat 29 May 2010 ($0)

Section 3: Payment Details

Total Payment:  by Visa MasterCard
Name on Credit Card:  CCV: What is CCV?
Card Number:  Expiry Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019