SUMMER INTENSIVE COURSE 2009 ENROLMENT FORM
                                                Monday 12th January to Friday 23rd January, 2009

               This is not an online enrollment form. Please fill in, print and send it to us with your payment details.
                               Return to: Centre of Italian Studies, 247 Cardigan Street, Carlton 3053
                                                    Telephone: (03)9347 9144 Fax: (03)9347 0175

Name:


The class I wish to attend is:

  -
* Prices include GST. Books are not included

Level Time
The following information is collected for statistical purposes and is considered confidential by CIS.
It will only be used within  the company. Please take your time to answer.

Gender  Age Occupation
Have you previously been enrolled at CIS?    Yes       No
Reason for studying Italian:  Travel Work Personal Interest Other: please specify
What led you to CIS?
 Print Ad:              The Age        The Age Gig Guide Melbourne Child   Yellow Pages Melbourne Times Internet:               Web Search           Google Ad            CIS web Site  
Radio & TV Ad:    FOX FM                NOVA FM             MIX 101 FM              Channel 31   
CIS:                      Flyer/Poster          Passing by CIS     Word of Mouth      Other

What made you choose CIS:
Recommendation      Brochure          Emphasis on Conversation         Levels Offered       Only Italian Taught       Free Extra Classes    Location      Value for Money    Telephone Information    Web Site Flexible Times      Reputation

CONDITIONS OF ENROLMENT (click here)
Please find enclosed my cheque/credit card details for $ (Cheques payable to CIS). I agree that this payment
entitles me to attend Italian classes at CIS during  Summer Intensive, 2009 and I have read the conditions and agree with them.
Signature _____________________________
-------------------------------------------------------------------------------------------------------------------------------
Mastercard/Visa/Bankcard/Amex*/Diners* (*3% Surcharge applies for Amex & Diners)                      Cardholder's Name ___________________________
Card Number:
Bank Transfer details: Acc Name: CIS Language Centre PTY LTD / BSB: 083170 / Acc Number: 455615108/ Please put in your name as the reference.
Cheque/Cash/CC/EFT Date _________________ $______________ Confirmed R.I./Post/Tel.    Reg___________DB__________