Teapot Valley Summer School Enrolment Form

Personal Details

First Name*

Last Name*

Address 1*

Address 2

City/Town*

Postal Code*

Country*:

Email *

Phone

Fax

Mobile

Enrolment/Accommodation Info

Voice Type*:

Age Range* (for room assignment):

Enrolment Options* (click here for more info):

Payment Options*:

*Required

Mailing Address:
Inga Lane
1/5 Alton Street
Nelson 7010
Please make cheque payable to: NZCCO

Direct Banking:
NZCCO Account No: 03 1354 0108005 00
Include your initials and last name for our records

Special Instructions

Vegetarian  Yes No