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PCE: Professional & Continuing Education

 The University of Adelaide Australia
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PCE
Level 9, 115 Grenfell Street
The University of Adelaide
SA 5005 Australia
Email

Phone: +61 8 8313 4777
Fax: +61 8 8313 4411
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Are you registering a group or on behalf of someone else?

This form is for Professional and Personal Development courses only.
 
Use this form if you are wanting to:
  Register on behalf of someone else.
  Register more than one person into a single or multiple courses.

Complete this online registration form and submit. PCE will process your enrolment and you will be sent an invoice for payment via email. Please allow 2 business days for processing. Please note your invoice will serve as confirmation of your enrolment.

Please select an appropriate billing method:
I wish to receive individual invoices for each participant. I wish to receive one invoice for all participants.

Important: This is not a payment form - do not include payment details on this form.

Payment of your invoice can be made easily by the following methods:
In Person: Level 9, 115 Grenfell Street, Adelaide Professional and Continuing Education Enrolments, The University of Adelaide SA 5005
By Phone: (08) 8303 4777 Credit Card Only By Fax: (08) 8303 4411 Credit Card Only
Please make all cheques payable to: The University of Adelaide

* indicates required fields.

 

Your Details

You will be the contact for enrolment and payment for these participants.
Your Title: *
Your First Name: *
Your Surname: *
Business Title:
Organisation/School:
Your Email: * invoices will be sent to this address
Billing Address: *
Suburb: *
State: * Postal Code:*
Telephone: (W) * (M) (F)

Your Details

Course Title:
Course Title:
Course Title:
Course Title:
Dietary Requirements Vegetarian Gluten Free Dairy Free Other No
To assist our Customer Service Planning, please indicate how you found out about the course. How would you like to receive promotional material?
The Advertiser
Messenger
Word of Mouth
School
Flyer
Letter
Brochure
Website
Email
Other: 		Email Only
Hard Copy & Email
Hard Copy Only
Please do not send me promotional material.
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Participant 1

Participant's Title: *
Participant's First Name: *
Participant's Surname: *
Participant's Email: *

Billing Address:
leave blank if the same as above

Suburb:
leave blank if the same as above
State:
leave blank if the same as above 		Postal Code:
leave blank if the same as above		  
Telephone: (W) * (M) (F)

Participant 1 Course Details

Course Title:
Course Title:
Course Title:
Course Title:
Dietary Requirements Vegetarian Gluten Free Dairy Free Other No
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Participant 2
Participant's Title: *
Participant's First Name: *
Participant's Surname: *
Participant's Email: *

Billing Address:
leave blank if the same as above

Suburb:
leave blank if the same as above
State:
leave blank if the same as above 		Postal Code:
leave blank if the same as above		  
Telephone: (W) * (M) (F)

Participant 2 Course Details

Course Title:
Course Title:
Course Title:
Course Title:
Dietary Requirements Vegetarian Gluten Free Dairy Free Other No
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Participant 3
Participant's Title: *
Participant's First Name: *
Participant's Surname: *
Participant's Email:*

Billing Address:
leave blank if the same as above

Suburb:
leave blank if the same as above
State:
leave blank if the same as above 		Postal Code:
leave blank if the same as above		  
Telephone: (W) * (M) (F)

Participant 3 Course Details

Course Title:
Course Title:
Course Title:
Course Title:
Dietary Requirements Vegetarian Gluten Free Dairy Free Other No
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Participant 4
Participant's Title: *
Participant's First Name: *
Participant's Surname: *
Participant's Email: *

Billing Address:
leave blank if the same as above

Suburb:
leave blank if the same as above
State:
leave blank if the same as above 		Postal Code:
leave blank if the same as above		  
Telephone: (W) * (M) (F)

Participant 4 Course Details

Course Title:
Course Title:
Course Title:
Course Title:
Dietary Requirements Vegetarian Gluten Free Dairy Free Other No
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Discounts: You may be eligible for a discount on the course fee. [read more]
Please note: Concessions and Discounts must be claimed at time of enrolment. Only one Concession/Discount type may be claimed.
Are you claiming a Concession/Discount? Yes No Number (if applicable):
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Is there anything else you wish to tell us about this registration?
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Refund and Cancellation Conditions
Professional and Continuing Education reserves the right to cancel, alter or amend any of its courses. Courses may be cancelled before the scheduled start date if the minimum number for the course is not reached, in such cases the full fee paid will be refunded.

Once your enrolment is processed, no refund of fees will be given. Adjustment Notes may be issued upon written request received 10 days prior to course commencement.

Transfers to another course will be considered providing they do not adversely affect course numbers.

Professional and Continuing Education regrets that we cannot accept responsibility for changes to participant’s commitments.

I have read and accepted the Refund and Cancellation Conditions (above), and understand that Professional and Continuing Education accepts your enrolment strictly in accordance with these conditions.

Copyright © The University of Adelaide
Last Modified 12/02/2012 Professional and Continuing Education
CRICOS Provider Number 00123M

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