Enrolment Form

Please refer to course information on this page, and contact us if you wish to enrol.

Given Name(*)

Please let us know your name.

Surname(*)

Invalid Input

Postal Address(*)

Invalid Input

Town(*)

Invalid Input

Postcode(*)

Invalid Input

Phone(*)

Invalid Input

Secondary Phone

Invalid Input

Your Email(*)

Please let us know your email address.

New or Continuing(*)

Invalid Input

Class Selected(*)

Invalid Input

Course Fees(*)

Invalid Input

AFCDN student membership(*)

Invalid Input

AFCDN Membership is compulsory for all students and needs to be renewed yearly (in January).

Alter Ego Plus books(*)

Invalid Input

Books can be purchased in app form for iPad or tablet.

Total $(*)

Invalid Input

Payment Method(*)

Invalid Input

Direct Deposit
NAB - Molesworth St, Lismore
Acc Name: Alliance Française Côte du Nord Inc
BSB: 082-707
Acc No: 21 839 2289
* Remember to include your name & a description of your payment
or
Cheque - payable to "Alliance Française Côte du Nord Inc"
PO Box 6061, South Lismore NSW 2480

Terms & Conditions(*)

Yes Invalid Input

I have read the terms and conditions

How did you hear about this class?(*)

Invalid Input

Photo Permission(*)

yesno Invalid Input

I give permission for photos of myself
to appear on the website

Questions or Comments

Please let us know your message.

In the box above, please note any questions, comments or further information.

(*)

Invalid Input

Alliance Française Côte du Nord

Enrolment Form

Learn French

Upcoming Events