Training in Postnatal Depression &
Perinatal Mental Health Issues.©

BOOKING FORM

This is an interactive booking form. It will check your entries, calculate the total cost, e-mail the completed form to us and send a confirmation e-mail to you.
If you prefer, you can print an empty form, complete it by hand and mail it to us.

Booking Form
Course Required:
Select one:		Thursday 27th and Friday 28th October 2011
		Waiting List

(Principal) Delegate Details
Title*		Forename*		Surname*
Job Title
Department
Organisation
Address*
Post Code*		Tel. No.*		E-mail*
Special Needs	Diet
	Other
Other Delegate Details:
Please provide the names, addresses, contact details and "Special Needs" for any other delegates included in this booking. Specify as "NYI" any delegates that are "Not Yet Identified". When known, e-mail NYI details to: "info@pndtraining.co.uk".


Proposed Method of Payment		Cheque	Cheques payable to "Post natal depression Training". Required 30 days before course, in order to secure place. (See terms and conditions of booking)
		Invoice	Invoices can only be raised against official Purchase Orders. P.O.s should be obtained from your authorising manager. Unless a Purchase Order Number is entered in the "Invoice Payment Details" this form will be rejected.
		Provisional	Neither cheque nor purchase order number available.

	I have read and accepted the terms and conditions of booking*.				Open terms and conditions in new window (requires javascript)

Invoice Payment Details [where different to (principal) delegate details]
Purchase Order No.		Contact for invoicing
Address
Post Code		Tel. No.		E-mail

* denotes cells that must be completed
When completed, this form will be sent to:		*Jane Hanley , PMH Training, Grove Hill, Golden Grove, Carmarthen, Carms. SA32 8NW*
Booking queries:		*07791 032 025*

Training in Postnatal Depression & Perinatal Mental Health Issues.©

Training in Postnatal Depression &
Perinatal Mental Health Issues.©