ICC Class Registration 2018
Check Website for course dates.

Privacy: Your data will not be shared with any external agencies and will be seen only by staff and tutors of the Irish Cultural Centre Hammersmith.
What class would you like to register for?
Name: *
Your answer
Address:
Your answer
Date of Birth (dd/mm/yyyy):
Your answer
E-mail Address: *
Your answer
Telephone Number: *
Your answer
Occupation:
Your answer
Is this your first time participating in the Irish Cultural Centre Education Programme?
If you answered 'No' to the last question please tell us which class:
Your answer
Are you Irish Born?*
*Not a requirement
Are you of Irish decent?*
*Not a requirement
How did you hear about the centre?
Your answer
How would you like to pay? *
Paypal link will appear for everyone once submitted regardless of answer.
Do you accept the terms and conditions as stated below: *
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I confirm, by signing below, that I have read and accepted the terms and conditions of subscription and participation in the ICCH Ltd Education Programme* and all information given is up to date and correct. *
Please sign by typing name and date.
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Your answer
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