Interior Design 101 Workshop

Registration Form
Design to Inspire Nancy Malekpour MDIA Interior Designer Ph: 0401 050 755 ABN 52 330 911 588

Section 1: Details of Person Registering

Please Tick: Mr Mrs Ms Miss

Family Name:

Given Name:

Address:

Suburb: Postcode: State:

Phone Mobile:
(Daytime):
Phone (Home): Email:

Age Group: 18-24 25-34 45-54 55-64 65 +

** Very Important: Please write legibly. Once payment is recieved, you will recieve a confirmation via email.

Section 2 : Additional Family Member (if Attending)

Please Tick: Mr Mrs Ms Miss

Family Name:

Given Name:

Address:

Suburb: Postcode: State:

Phone Mobile:
(Daytime):
Phone (Home): Email:

Age Group: 18-24 25-34 45-54 55-64 65 +

Section 3: Masterton Homes - Your Home Details

Your Masterton Homes JOB Number:

Home Design Name:

Facade Type:

Garage Side: (Please Tick) Left facing: Right facing:

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Design to Inspire Nancy Malekpour MDIA Interior Designer Ph: 0401 050 755 ABN 52 330 911 588

Section 5: Dress Code

Casual Clothing, in your favourite Colours.

Suitable Footwear is required i.e. Shoes must be fully Closed In.

Section 6: Payment Method

Please note: Payment is Required 7 Days prior to the Workshop Date

Payment via Direct Debit:

Account Name: Design To Inspire

Bank: Commonwealth Bank of Australia

BSB: 062 314

Account Number: 1007 4246

Please quote your "Full Name" on the Bank transfer Reference

Section 7: What to Bring Along With You

Bring Along:
Any inspirational images or photographs from magazines, etc (Interior or Exterior)
Your Camera to take a photo of the Sample Board you will create.

Section 9: Agreement

Very Important: Please write legibly. Once payment is received, you will receive a Confirmation via email. I understand that I am
not registered until my payment is received. In the event the Workshop must be Cancelled by the Organiser/s, for any deemed
sufficient reason, Full Refund will constitute full settlement with the applicant. An alternative date will be offered. In the event an
attendee withdraws two days from the scheduled Workshop, no refunds will be made. In the event an attendee withdraws three
days from the scheduled Workshop, a $100 non-refundable administration charge will apply. As we do not have Child Care
facilities, please refrain from bringing your kids to the Workshop. We
thank you for your understanding and your co-operation.

Full Name:

Signature:

Date:

Please sign and Send your Registration Form (via Fax or email) to:
Ms Nancy Malekpour
Fax: 9602-0184 or Email: nancy.malekpour@masterton.com.au
Within 24 hours, upon receipt of this form, you will be contacted by Nancy Malekpour
who will arrange a Reservation for your most suitable day.

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