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Beauty Therapy Application for Enrolment
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Title
Last Name
First Name
Date of Birth
Mr
Mrs
Miss
Ms
Dr
Sir
Street Address
State
Country
Post/Zip Code
Home Telephone
Work Telephone
Fax Number
Email
Address in Australia (if known)
Street Address
Suburb
State
Postcode
Gender
Country of Citizenship
Country of Birth
Male
Female
Name of course you are applying for
Are you applying for exemptions? (if yes, please explain)
Declaration
I declare that the information I have supplied on this form is, to the best of my undertanding and belief, complete and correct. I understand that the giving of false or incomplete information is illegal, and that I may be proscecuted under Australia's laws and statutes.
Applicants Name
Dated:
By checking this box, you agree to be bound by the above declaration. This document is legally binding and by agreeing to it's terms and conditions, you are entering into a contract with AIAS, should your application be accepted. This application form in no way implies any liability on the part of AIAS and further that completing this application form does not guarantee any place in any course offered by AIAS.
