Registration form for class/workshop2 with Carol Squires, Astrologer

Please complete the details, print this form and post payment to Carol (see details below).

Please enrol me in the following Astrology on Sunday workshops:

31 August
28 September
19 October
23 November
(delete whichever is unapplicable)

Personal Details Name:
Address:
City:          Postcode:
Country:
Phone:     Fax:
Email:

Birth data Time:       am / pm
Date:
Town:
Country:

Payment
Please make cheques payable to Carol Squires Astrologer.
I enclose my cheque to cover 4 Workshops $280.00*.
I prefer to pay class-by-class and enclose my payment of $70.00

Signature:

Date:

Please post to: Carol Squires, Astrologer, 35 Eastcliffe Road, Castor Bay, North Shore City 0620.

For direct bank transfers please place into the following account:
Carol Squires Astrologer, ANZ Bank Milford, Auckland, New Zealand
A/c # 010178 0147771 00
and phone or email your details to Carol.