NIE UCAT Course Application Form

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First Name*

Please type your full name.

Last Name*

Please type your full name.

Postal Address*

Suburb*

Postcode

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State*

-=Select=-VICNSWQLDTASNTACTWASAOther Invalid Input

Please specify

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Country*

-=Select=-AustraliaNew ZealandOther Invalid Input

Please specify

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Phone No.*

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Student's E-mail (required)*

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Parent's E-mail (required)*

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Current School Name*

I am in Year (10, 11, 12)*

In Case of Emergency (name / phone)*

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How did you find us?*

-=Select=-Google AdsMail Promo LetterPro Training (PTTI)The HSC and Careers Expo (Sydney)The AGE VCE and Careers Expo (Melbourne)School NewsletterTeacherSchool PosterSchool Careers DayDr Kiah's Tuition student ( HCC /group discount does not apply)Word of MouthFriendSiblingSchool SeminarBrochureGoogleYahooAnother search engineFacebookYouTubeOther Invalid Input

Please specify

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Group Application*

-=Select=-YesNoDr Kiah's tuition - group or HCC discount does not apply. Invalid Input

If yes, please list names.*

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Course Package*

Workshop only - 150.00 AUD
Workshop + Add-on # 1 - 189.00 AUD
Workshop + Add-on # 2 - 215.00 AUD
Workshop + Add-on # 1 & 2 - 254.00 AUD
Workshop + Add-on # 2 & 3 - 295.00 AUD
Workshop + Add-on # 1, 2 & 3 - 334.00 AUD
Workshop + Add-on # 1, 2, 3 & 4 - 684.00 AUD Invalid Input

Dietary food requirements?*

Yes No Invalid Input

Please specify your dietary requirements*

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UCAT Workshop*

-=Select Your Workshop Date=-SAAdelaide -15 June 2019 - Saturday QLDBrisbane - 3 July 2019 - Wednesday (Sc.Holidays)VICMelbourne - 8 June 2019 - SaturdayMelbourne - 5 July 2019 - Friday (Sc.Holidays)WAPerth - 25 May 2019 - Saturday NSWSydney - 9 June 2019 - SundayBlacktown - 22 June 2019 - Saturday Invalid Input

Interview Workshop*

-=Select=-Adelaide - 28 September 2019 - SaturdayAdelaide - 16th November 2019 - SaturdayAdelaide - 17th November 2019 - Sunday Brisbane - 31st August 2019 - SaturdayBrisbane - 5th October 2019 - SaturdayBrisbane - 14th November 2019 - ThursdayBrisbane - 15th February 2020 - Saturday Canberra - 12th October 2019 - Saturday Melbourne - 25th August 2019 - SundayMelbourne - 26th September 2019 - Thursday (Sc. Holidays)Melbourne - 20th November 2019 - WednesdayMelbourne - 14th December 2019 - SaturdayMelbourne - 22nd December 2019 - SundayMelbourne - 29th December 2019 - SundayMelbourne - 18th January 2020 - SaturdayNewcastle - 12th November 2019 - TuesdayPerth - 17th August 2019 - Saturday Perth - 22nd November 2019 - FridayPerth - 23rd November 2019 - SaturdayPerth - 24th November 2019 - SundayPerth - 25th November 2019 - MondaySydney - 24th August 2019 - SaturdaySydney - 6th October 2019 - SundaySydney - 3rd November 2019 - Sunday Sydney - 9th November 2019 - Saturday Sydney (Castle Hill) - 10th November 2019 - SundaySydney - 15th December 2019 - SundaySydney - 5th January 2020 - Sunday Invalid Input

Payment Method

PayPal / Credit CardBy Credit Card over the PhoneDirect Deposit, Cheque or Money Order

Total Price

0.00 AUD

Postage*

Select Postage (Compulsary Field)1 Book (within Australia) - 9.95 AUD2 Books (within Australia) - 11.95 AUD3 Books (within Australia) - 13.95 AUD4+ Books (within Australia) - 15.00 AUD====Select Postage (Compulsary Field)1 Book (New Zealand) - 29.00 AUD2 Books (New Zealand) - 34.00 AUD3 Books (New Zealand) - 39.00 AUD4 Books (New Zealand) - 44.00 AUD5+Books (New Zealand) - 59.00 AUD====Other Countries (inquire) Invalid Input

Terms & Conditions

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Acknowledgement*

I acknowledge and agree to the above terms and conditions. Invalid Input

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