Booking Form

Name

Company if applicable

Address

Post Code

Tel No

Mob Tel

E-mail address

Course Title:

Course Date 

Course Location - Sherwood Place - Bletchley

Course Time 

Course Cost …£

20% Deposit £          

Amount outstanding…£

Purchase order

I wish to pay by cheque (payable to PJ Care Developments Ltd),

BACS  (Ask for details) 

Debit or Credit Card (MasterCard, Visa, Visa Electron, Solo, JCB Cards, American Express).

Card Type:…………………………………….Card Number:……………………………………

Valid from:………………Expiry Date:…………………..*Issue No if appropriate)………….

Name/Initials on Card:………………………Three-Digit Security Code:……………………..

Or Invoice to (if different to above):……………………………………………………………….

………………………………………………………………………………….Post Code………..

Please return this form as soon as possible to secure booking.

 Deposit of 20% is payable at time of booking.

Name(s) of Attendees