~~~Please fill out the form below and either post it in to us, or alternatively drop it into our office.
If you would simply like to register your interest in WEA and our courses then please click here and fill out our register interest form.
Register Your Interest Here~~~

CWEA ENROLMENT/PAYMENT FORM - please print this page

Mr/Ms/Miss/Mrs:...................................................................................................

Address:...............................................................................................................

Telephone: Home............................... Work...........................................................

Email:..................................................................................................................

Course Number	Course Title	Members' Concession	$Fee
.....................	....................................................................	.....................	.....................
.....................	....................................................................	.....................	.....................
.....................	....................................................................	.....................	.....................
Would you like to become a member? ($10 per person, $15 per family, $150 life member, $15 affiliate)			.....................
Optional Donation (Tax Deductible) to help us continue offering programmes for the community			.....................
		Total: Cash/Cheque/eft	$....................

Office Hrs: 9:30am-3pm Mon-Fri
Tel: (03)366 0285
Fax:(03)366 4530
Web: cwea.org.nz

For office use only:
Processed by: ..............

Membership #: ...............

Receipt#............................... Date..............................

Please make cheques payable to: Canterbury WEA, 59 Gloucester St, P.O. Box 1796, Christchurch.
Unless you are advised otherwise you are accepted for your course

FOR STATISTICAL PURPOSES ONLY:

(to help with our marketing)
How did you hear about our courses?
Received programme by mail
Newspaper Webpage
Library Other

Required by the Tertiary Education Commission -
Age:
Under 20 20-29
30-39 40-49
50-59 60+
Ethnicity:
NZ European/Pakeha/European Maori
Pacific Islander Other; please specify ......................