401 Canterbury Road, Surrey Hills, 3127. PH. 98807257 Fax 98807267
Email: info@marjoriemilner.edu.au

Enrollment Form

Day\s of preference ………………………………………………………...

Course ......................................................................................................... 

Name ……………………………………………………. DOB ………….

Address …………………………………………………………………….

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Telephone (Work) ………………………………………

Telephone (Mobile)……………………………………..

E-mail Address ……………………………………………………………

Emergency Contact.

Name …………………………. Relationship to student…………………..

Address …………………………………………………………………….

…………………………………………………… Postcode ………….......

Telephone (Home) ……………………...... (Work)……………………….

Mobile …………………………………………….

Will you be working full or part time in a retail floral studio during this course? (Please circle)        Yes             No

What influenced you to select Marjorie Milner College?

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