Course Attendance Register

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This form is to be used for those people who are attending a computer/technology course.

We use this information to know who is current in the building in case it needs to be evacuated in an emergency as well as providing us information for the promotion of future courses

Last Name *

Your Surname/Last Name

First Name *

Your First name

Phone Number (Land Line)

Your Land Line Phone Number we can contact you on

Mobile Number

Mobile Phone Number we can contact you on

Email Address

The Email Address we can contact you on

Name of person running the course *

The name of the course instructor/tutor/teacher

Any other coments remarks

Information not catered for elsewhere

Would you like to register for other future courses *

Select Yes or No

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This form was created inside of Logan Area Committee on the Ageing. Report Abuse

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