Manual Registration Form (only use if advised by Alpha staff)

Use this secure form to provide your details for an AlphaCC salesperson to book a course or book for onsite consulting on your behalf.

Once you have decided on the course you want to do, please follow these simple steps:

1. First ring us for special offers and course availability. 1300 880 860
2. Then complete the form below.
3. Click on the Register me now button at the bottom of the form and an AlphaCC consultant will complete an online registration form on your behalf.

We will then contact you with confirmation and payment details.

Advice when completing the Registration Form:

1. Please complete Registration Form for each participant for up to 3 courses.
2. If you have multiple participants for one course, then enter all names into the "Participant Name" field.
3. Additional names can be entered into the "Comments" field.
4. Your registration will be processed and you will receive by email an invoice and confirmation, pending payment.

Payment Details

Terms and Conditions (click to view)

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Company Name:
Contact Name:
Street Address:
Suburb:
State:
Postcode:
Country:
* Telephone (Business):
Telephone (Mobile):
Telephone Accounts:
Does the course Participant use Windows or Macintosh?:
* Email:
* Participant Names:
Participant Job Title:
How did you find us:

* Course 1:
Workshop Title (if applicable):
eLearning Package (where available)		I want to purchase this option and accept the licence restriction:
		(one-user licence, restricted to class attendee)

Course 2 (if required):
eLearning Package (where available)		I want to purchase this option and accept the licence restriction:
		(one-user licence, restricted to class attendee)

Course 3 (if required):
eLearning Package (where available)		I want to purchase this option and accept the licence restriction:
		(one-user licence, restricted to class attendee)

Course 1 Preferred Date:
Course 2 Preferred Date:
Course 3 Preferred Date:
Training Centre:		Sydney: Canberra: Melbourne: Brisbane: Other:
Total Amount Due: $
Payment Method:		Cheque: Direct Deposit:
		Credit Card (M/V/B/AMEX): (2.5% Credit Card Fee Applies)
		Mastercard: Visa: Bankcard: AMEX:


Alpha Sales Rep. Name:

Comments:
Subscribe to Training Updates:		Yes: No:

* I accept terms & conditions (below)		Accept: (read terms below and tick to accept)
		* indicates required fields