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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

Please make sure DOB are correct to ensure a smooth entry upon arrival at prison.
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
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Who else will attending on the day?

First Name
Last Name

Please make sure DOB are correct to ensure a smooth entry upon arrival at prison.

First Name
Last Name

Please make sure DOB are correct to ensure a smooth entry upon arrival at prison.

First Name
Last Name

Please make sure DOB are correct to ensure a smooth entry upon arrival at prison.

First Name
Last Name

Please make sure DOB are correct to ensure a smooth entry upon arrival at prison.

First Name
Last Name

Please make sure DOB are correct to ensure a smooth entry upon arrival at prison.
*
*

Please note that not all items are guaranteed entry into the prison, however we will let you know if anything isn't allowed.

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