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Jean Jacques Pty Ltd, 24 King Street, Adelaide, Australia 2500. Contact us at: jeanjacques@jj.com.au
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Member Registration Form
Parent Detail (1 / 4)
Name
*
Customer Name
Phone
*
-
ex: 03 - 98877228
Email
ex: yourname@yourdomain.com
Street Address
*
City
*
State
*
Victoria
Postcode
*
Communication
Communication means to contact customer
Date of Birth
*
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Nationality
*
Australia
ID Card Number
*
ID Card Type
*
Driving License
Personal Information
Customer identification when needed
Number of Children
*
to be Registered
1
Children to Register
Only number of children that would like to be registered to the center
*
means mandatory
Registration procedure:
1. Parent Detail
*
2. Children Detail
3. Payment Detail
4. Online User Detail
(1 / 4)
