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OFFICIAL APPLICATION FORM(Please print this form)
Name/Surname:______________________________________
Address: ______________________________________
__________________________________________________
Telephone: (Home)____________ (Work) ________________
Fax: _________________________
E-mail Address:___________________________________________
Age: ______________________________
Amount Enclosed: ____________________________________
Date: __________________ Signature: __________________
FOR OFFICIAL USE:
Membership Period: _________________________________
Please return to:
Shanaaz Parker Culinary Academy,
P. O. Box 117, Retreat, 7965, South Africa
Fax: +27 21 7011701
E-mail:info@shanaazparkercooking.com
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