SLE Registration

Course Information

Your Details

Name*

First Last

Date of Birth*

Email*

Phone (Mobile)*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Religion*

Sex*

Male
Female

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Fiance Details

Name - fiance*

First Last

Date of Birth - fiance*

Email - fiance*

Phone (mobile) - fiance

Religion - fiance*

Sex - fiance*

Male
Female

Do you live at the same address?*

Yes
No

Address - fiance*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Wedding Details

Wedding Date

Leave blank if you have not yet set a date.

Celebrant/Priest

Location of Wedding

(Suburb, State, Country)

Message

Any information that would assist us in giving you the best possible support at this time, such as dietary restrictions, special needs, preferred mentors, details for overseas wedding etc.

Please select your payment method*

Standard enrolment $310
Payment Plan (preauthorised by our team)
Gift Certificate

SL Engaged Course*

For Group courses or Mentoring. Price is per couple.

Price: $ 310.00

Payment Plan*

If you have negotiated a special payment plan with our team, please indicate the amount here. If you have provided your credit card details to our team for manual processing, put 0

Gift Certificate Details & Code*

Donation

Would you like to make a donation to support the work of SmartLoving? All donations to the PMRC Relationship Education Foundation over $2 are tax deductible.

Total

$ 0.00

Credit Card

American Express

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Card Number Expiration Date Security Code Cardholder Name

*

I have read and agree to the Terms and Conditions

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Register Now for SmartLoving Engaged

Please complete the form to register and pay for your course. If you require financial assistance, please call our office before you complete this form on 02 9319 6280

Course Information

Your Details

Fiance Details

Wedding Details