THE DUKE OF CORNWALL SPINAL TREATMENT CENTRE
Community Occupational Therapy Study Day
Tuesday 24th November 2015
BOOKING FORM
Name of Contact: (Please Print)
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Department: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Telephone No: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Names of attendees
Employer
Cost: £80 per person – including lunch and refreshments
PLEASE LET US KNOW TO WHOM THE INVOICE SHOULD BE ADDRESSED:
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PLEASE INDICATE ANY DIETARY REQUIREMENTS (including allergies):
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An invoice will be sent to you from our Finance Department prior to the Study Day, (cheques should be
made payable to Therapy Staff Fund 1335).
Please return this booking form to:
Catherine Whitmarsh
Therapy Team Lead
The Duke of Cornwall Spinal Treatment Centre
Salisbury District Hospital
Salisbury
Wiltshire, SP2 8BJ
If you need to cancel a booking, please contact us 14 days prior to the course date. Failure to attend
without prior cancellation will regrettably result in full payment being due.