Online Enrolment Form | Geelong West Neighbourhood House

You may enrol in an activity online by completing the following form. Please note that your place in a desired activity is not guaranteed until payment has been confirmed.

The course will go ahead if minimum numbers required are enrolled.

Payment for activities may done by Direct Debit to our bank account, in person at the GWNH Office on Mondays 10am - 12 noon, or by prior arrangement.

The GWNH Office is located at the rear of the Geelong West Community Hub, 89 Autumn Street, Geelong West, 3218.

Our Bank Account details are as follows:
Bendigo Bank, BSB: 633-000, Account No: 143942050

Please state your name & course code in the lodgement reference.

Activity Information

Activity Name *

Activity Code *

Method of Payment

Please let us know how you are going to pay your activity fees.

Direct deposit to our bank account is preferred. GWNH Bank details are:
Bendigo Bank, BSB: 633-000, Account No: 143942050

Method of Payment *

Contact Details

First Name *

Last name *

Address *

Postcode *

Phone Home

Phone Work

Email Address *

Please tell us how you heard about us and/or this activity:

Please tell us how you heard about Geelong West Neighbourhood House and/or this activity you wish to enrol in.

Other

E-Newsletter

We send out a monthly newsletter via e-mail showcasing our program, activities, and events.

Comments

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Comments

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