CDU/AIM Short Course Enrolment Form

Enrol by filling in this form and submitting it securely online. Alternatively you can print out and fax the completed form to 08 8946 6822.
* indicates information required for submission

Delegate Details
Title
First Name/s* Surname*
Position/Title/Rank*
Organisation*
Home Address
Phone*
Facsimile
Email*
Membership*




Member Number
Individual Needs eg. Dietary requirements, wheelchair access

Privacy
We may use your Personal Information to tell you about our products and services and may disclose it to Approved Third Parties (see our Privacy Statement). If you would like further informatin on AIM's Privacy practices, or on how to access your Personal Information, view our Privacy Statement at www.aimnt.com.au.
Course Details
# of Delegates
Course Intake Date Campus
 
Authorising Officer
Title
First Name/s Surname
Position/Title/Rank
Organisation
Postal Address
Phone
Facsimile
Email
 
Payment Details

Your payment details will be securely forwarded to Charles Darwin University where remittance will be taken. A CDU representative will contact you in regards to your enrolment.

All prices include GST.
 

Card Type*
Card Number* Expiry Date*
Name on Card*


or print out and fax the completed form to 08 8946 6822

2000 - 2008 Australian Institute of Management. ABN 40 009 668 553.
Email questions and comments to AIM Enquiry or call 13 16 48.