Registration Form

PO Box 34 Mittagong NSW 2575 Australia
FAX: 02 4871 1903

  
This form, completed, accompanied by a fee of $220 (inclusive of GST) and signed by a parent/guardian ensures a student's name is registered on the waitlist of Gib Gate. If you prefer to print a copy, a printer friendly version is provided. Payment can be made by Cheque, Credit Card or Direct Deposit, these details are available on the confirmation email.

* Required
 
 Student Information
Yes No
Yes No
No Aboriginal Torres Strait Islander
Both Aboriginal and Torres Strait Islander
Yes No
If so, Maiden Name?
Yes No
 Mother's Details
 Father's Details
 General
Former student
Advertising
Always Known
Word of Mouth
Other
Credit Card
Cheque/Money Order
Direct Deposit
Enter Verification Code
Captcha Image