Booking Form
Course Required:
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Tuesday 22nd March-Thursday 24th March 2011
Waiting List
(Principal) Delegate Details
Title*
Forename*
Surname*
Job Title
Department
Organisation
Address*
Post
Tel.
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.
Course Fees*
No.
£ Total
Full course, including meals and three nights bed and breakfast accommodation (with en-suite facilities).
1350.0
Discount (per night) if bed and breakfast not required.
97.00
Each additional bed and breakfast
97.00
University accommodation for the night prior to each day's session is included.
Total (ex VAT)
VAT @ 17.5%
Overall Total
Proposed Method of Payment
Cheque Cheques payable to "Post natal depression Training". Required 30 days before course, in order to secure place.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 theterms and conditions of booking* .
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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,
Jane Hanley , PMH Training, Grove Hill, Golden Grove, Carmarthen, Carms. SA32 8NW
Booking queries:
07584 498166
