Bibiani

                   Enrolment application

Please enclose payment when enrolling - refunds will be made only if notice is given.

Class .........................................................................

Name(s) .......................................................................

.................................................................................

Postal Address ............................................................

................................................................................

..........................................................P/Code..............

Contact telephone.........................................................

E-mail ..........................................................................

Payment of $........................ is enclosed

Payment by credit card:

Type of card:  Visa   ...        Master card   ...    

Number _ _ _ _ / _ _ _ _  / _ _ _ _ / _ _ _ _

Expiry date.....................................

Name on card................................................................

Signature ....................................................................

Please post this form to Bibiani Studio, c/- 11 Pillinger Drive, Fern Tree, TAS 7054

or bring it into the studio. Please don't post to the studio.

Direct Deposit details: Bank account is BSB:067 102 Acct no: 10076149

Please e-mail to notify payment.

Concessions are available on request and on presentation of concession card or seniors card.

Contact studio.