Name..................................................... Telephone No......................................................
Address............................................................................................................................
........................................................................................................................................
........................................................................................................................................
My e-mail address (if applicable)..........................................................................................
Name of course I wish to attend..........................................................................................
Venue/Location of course I wish to attend.........................................................................
Date of course I wish to attend...........................................................................................
I have enclosed the deposit payable to Jan Kilpatrick.
Please send me confirmation of my
place on the course and further details on location, starting times and any details
specific to my course. I understand that I must pay the full balance at least two weeks before the course commences.
I found out about the course through.....................................................................................
