Executive Education Enrolment Form

Title
First Name *
Surname *
Position
Company/Organisation *
Postal Address *
City *
Postcode *
Phone *
Dietary Requirements
I wish to confirm my enrolment on the following course/s: *
Payment Preference
$
Billing Address *
City *
Postcode *
Please specify any other courses you might be interested in attending:
How did you hear about our courses?:

Conditions of Enrolment - The University may cancel any course because of insufficient numbers or other unforseen circumstances. The University of Otago is not responsible for any expenses (e.g. books/travel/accommodation) that have incurred.*Early Bird Discount does not apply to already discounted rates.

Cancellation Policy - One month's written notice is required for a full refund (before start of course). Within one to four weeks' notice fees can be transferred to another course or 50 per cent of fees will be refunded. With less than one week's notice, no refunds apply.

Fee includes tuition, course materials, all meals and five nights' accommodation at the Executive Residence. We will invoice you/your organisation following your attendance on the course.

Signature (type your full name) *
Date *
Sorry, but we have to ask!

How to Apply

Complete the enrolment form.

This can also be faxed to:
Fax 03 479 4146

Or posted to:
Executive Education
School of Business
University of Otago
PO Box 56
Dunedin 9054
New Zealand