Follow Up Program Registration Form

Select Program *
Use this form to request your place on a program waiting list. Once you submit this form please download the Program Information Pack. We do not offer refunds less than 6 weeks prior to the program, however you are welcome to switch to a later program so please consider carefully prior to making a booking. If you have any questions regarding the bookings form or procedure you can email the Bookings & Communications Manager at info@mittagundi.org.au. They will usually get back to you within 3 business days.
Participant Name *
Participant Name
Booking Person's Name *
Booking Person's Name
Home Address
Home Address
Date of Birth *
Date of Birth
Waiting List Application *