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Personal Information

Full Name:*

Date of Birth:*

 

 / /
Address:*
Postcode / Zip:*
Email:*
Mobile Phone:*
Telephone:*

 

Educational Information

Number of years architectural education completed at recognised / accredited school:
Institution(s):
 
Degree(s) / Diploma(s): completed:
  completed:
Other Qualification(s): completed:
  completed:

 

Practice Information

Employer(s): from: to:
  from: to:

 

Other Information

In what country were you born?
In what country is your permanent residence?
Are you proficient in spoken English?
Do you have any disabilities or impairment(s)?
If yes, please provide details?
 
Please state briefly why you are interested in participating in the 2009 New Zealand Architecture Master Class:

 

Declaration

 

I declare that i have read the information on the official web site, and understand that this application for participation in the 2009 Glenn Murcutt International Master Class is subject to an official offer and subsequent payment of the full course fee.
Name in Full: