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Change of Preference Session Registration Form

Use this form to register your intention to attend the Change of Preference Information Session to be held on Wednesday 17th December 2008 from 4.30 - 5.30pm at the SMB campus, Brewery Building (maps available at www.ballarat.edu.au/maps) .

Please note: Fields marked with an * are required.

First name*:

Last name*:




Address*:

Town*:

Postcode*:

Phone*:

Mobile:

Email Address*:

Course interest areas*:

Your ENTER score*:

Please choose the option that best applies to you*: