Australasian Lactation Courses

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LACTATION COURSES FOR HEALTH PROFESSIONALS 2006  

REGISTRATION FORM

This course may also be done through an interactive workshop mode if 10 or more requests are received before 15th of January 2006 (only available in Adelaide). Please contact Jen Byrne on (08) 8271 8740 or email jen_byrne2000@hotmail.com.

Please send payment (cheque/money order) with registration form to:

Australasian Lactation Courses

P O Box 336, Unley  SA  5061, Australia

ABN 88 681 087 408

This form may be considered a Tax Invoice

Given Name:__________________ Family Name/Surname:______________________________________

Address:_____________________________________________________________________________

State________________________________________________Postcode:________________________

Phone:(_____)_______________________Email:_____________________________________________

Relevant qualifications:__________________________________________________________________________

Occupation:___________________________________________________________________________

Cost (please indicate the course you wish to do):

�          $(AUS)600 (includes GST) if doing course in Australia.

�         $(AUS)600 (GST exempt) if doing course outside Australia. Please send bank cheque for $(AUS)600