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NEW ENROLMENT FORM 2019 BLANDTHORN PERFORMING ACADEMY
Please ensure all details are correct and up to date prior to submitting.

Please fill in a different form for each child.

Single registration fee - $35
Family registration fee - $55


DIRECT DEPOSIT DETAILS
Name: Carol Blandthorn
BSB: 063 153
Acc #: 1035 9904

* Required

STUDENT INFORMATION 2019
Student name *
Your answer
PARENT/GUARDIAN 1 FULL NAME *
Your answer
PARENT/GUARDIAN 1 TELEPHONE NUMBER
PARENT/GUARDIAN 2 FULL NAME *
Your answer
PARENT/GUARDIAN 2 TELEPHONE NUMBER
Student address *
Your answer
Date of birth 00/00/00 *
Your answer
Age as of 01/01/2019
Your answer
Email address *
Your answer
Student's phone number (if applicable)
Your answer
INVOICING & NEWSLETTERS - Please select *
How did you hear about us? *
Your answer
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