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Contact Information
(The information you provide on this registration form will remain the property of FVPLS Victoria and will not be shared with anyone else)
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
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List all those who will be attending on the day

First Name
Last Name

First Name
Last Name

First Name
Last Name

First Name
Last Name

First Name
Last Name
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Please Note that these workshops provide hairdressing, other therapies and services to Koori women participants. We regret these services cannot be provided to your representative/s.

For more information, or to confirm your involvement, please contact FVPLS Victoria on (03) 9244 3333

Registration forms to be received at least five working days prior to the workshop.

 

 

If your having issues submitting this form online, please print registration

form and send via email/fax: Printable Registration Form