DELEGATE BOOKING
FORM
Short courses and Workshops
1
2014/15
BROADREACH TRAINING
BOOKING FORM
GENERAL INFORMATION – please read carefully
Fee:
£………. per person, paid in advance in cash, cheque or company invoice confirmation. Please make
any cheques payable to ‘Broadreach House’. (Fee includes course handouts, refreshments and lunch
where applicable)
Application:
All participants must complete the booking form below. If more than one of you wishes to attend,
the application form may be photocopied.
Confirmation:
You will receive a confirmation letter/email including further course information.
To change participants:
We are happy to change participants upon notification by phone or post.
Certificates:
These are only issued to participants who attend the entire programme and complete the
programme evaluation form.
Refunds:
Cancellation in writing up to 7 days prior to the course will lead to a full refund minus a £10
administration fee. Cancellations after this or failure to attend on the day will leave the individual
fully liable for payment. No refund will be made in such instances.
In the unlikely event of a natural disaster or illness, we reserve the right to substitute trainers and/or
reschedule the programme. If you are unable to attend the rescheduled programme you will be
given a full refund.
PLEASE BOOK EARLY TO ENSURE YOUR PLACE.
Course Title:
Course Date:
First Name: Mr/Mrs/Ms/Miss/Dr
Last Name:
Date of Birth:
Home Address:
Post Code:
Telephone Number:
Email Address:
Profession:
Any Dietary Requirements:
Any Physical/Mobility/Learning
Needs Requirements:
Please explain briefly why you wish to participate in this course?
Payment – Please Tick Your Option:
I enclose cash/cheque made payable to Broadreach House for £
I enclose an official invoice request/purchase order from my employer for £
If requesting an invoice: Purchase Order/Reference Number:
Name and Address of person/company to be invoiced:
Return completed booking form to:
Leo Haynes / Emily Summers
Training Co-ordinator, Broadreach Ocean Quay, Unit 2, Richmond Walk, Plymouth, PL1 4LL
Tel:
01752 566211
Email: leo@broadreach-house.org.uk / emily.summers@broadreach-house.org.uk