EmailMe Form - AMI Assistant Certificate Course

Name

First Last

School

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone: Daytime

Phone: Evening

Personal Email

Payment Options

Internet payment MMEF, ASB Bank 123048 0417212 00

Cheque payable to MMEF. Post to MMEF, PO Box 108054, Symonds Street, Auckland

For Internet Payment include as a reference: your name, your school, and "Assistant's Course".

Early Bird Registration $960+ GST
(to be eligible for Early Bird Registration, registration and payments must be received by Friday August 7, 2015)

Late Registration (after August 7) $1085 + GST
There can be no refunds after August 21, 2015