Workshop booking form

Please complete the following information.
Please complete a separate form for multiple bookings.
Questions marked * are required.

About the course

Course title *

Course date *

Tuesday 17 April 2012

Tuesday 10 July 2012

Thursday 27 September 2012

Monday 5 November 2012

Course fee *

£125 statutory, independent and large voluntary organisations (10 + employees)

£95 other voluntary organisations and individuals

About you

Your name *

Job title

Organisation

Address *

Postcode

Telephone *

Access or dietary requirements

Payment information

Amount payable * £

Payment method *

Cheque

Invoice

Your order number

For invoicing, please give contact name, phone number and address if different from above *

Where did you hear about the course?

Message

If you are paying by cheque please make it payable to 'Bristol Crisis Service for Women'
and send by post with your name and address to:
Bristol Crisis Service for Women, PO Box 654, Bristol BS99 1XH
Tel: 0117 927 9600 email: bcsw@btconnect.com

Confirmation of booking will be sent on receipt of form.
Final details and venue location map will be sent approximately 2 weeks before the workshop.
A refund of fees will be made for cancellations received in writing at least 14 days before the workshop (less a 25% cancellation fee to cover administration costs). We are happy to accept substitute delegates at any time.

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