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GIC CODE OF PRACTICE
This form may be printed from your web browser to be filled out, and mailed to GIC.
ENROLLMENT FORM 2001E
I apply to enroll for the above Examination
Membership No.
________________________________________________________________________
Name
________________________________________________________________________
Address
________________________________________________________________________
Tel: ___________________________
DATES AND MODULES
MODULE(S):
#1 ________ #2 ________ #3 ________
#4 ________ #5 ________ #6 ________
FEES:
$_______
GST 7%:
$_______
TOTAL FEES ENCLOSED:
$_______
Dates and Test Centers (in order of preference)
1. Date______________________ Center_____________________
2. Date______________________ Center_____________________
Single Module
$80.00
2 or more Modules on same day
$70.00ea.
6 Modules prepaid
$380.00
I agree to abide by the conditions of enrollment as laid down by the Grooming Institute of Canada.
Signed_____________________________________ Date_____________
Please make cheques payable to the
Grooming Institute of Canada
and mail to:
92 Lakeshore Road East
Concourse Level
Mississauga, Ontario
L5G 4S2
Tel: 905-278-9663
Fax: 905-278-1045
Code 0299