Application form for beginner course with Carol Squires, Astrologer

Please complete the details, print this form and post payment to Carol.

Please enrol me in the Astrology by Correspondence 10-lesson
(a) Beginner's course in Astrology;
(b) Intermediate course in Astrology; or
(c) Advanced course in Astrology
(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 bank draft payable in New Zealand dollars to Carol Squires.
I enclose my cheque/bank draft for the full fee of *NZ$280.00.
I prefer to pay in two instalments and enclose my first instalment of *NZ$145.00 and my second instalment of NZ$145 will be paid on completion of lesson 4.
I have paid the full fee of *NZ$280.00 by direct bank transfer.
* Take a look at the currency converter for equivalent local prices.

Postage Postage is included in the fee for New Zealand students only. If you do not live in New Zealand please make cheque/bank draft/direct bank transfer payable in New Zealand dollars to Carol Squires and add:
NZ$20 for Australian airmail postage.
NZ$40 for airmail postage outside New Zealand and Australia.

Please sign this form Terms and conditions
Payments for the correspondence course are valid for one year from date of application. No refunds once course has started. If payment is in two instalments the second instalment must be paid on completion of Lesson 4.

Signature:

Date:

Please post to: Carol Squires, Astrologer, Astrology by Correspondence, 35 Eastcliffe Road, Castor Bay, North Shore City 0620, New Zealand

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.