Booking Form

Working Together, Releasing Potential, Supporting Success

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General Information

Title

Mrs

Miss

Other

Full Name *

Position/Job title *

Date of Workshop *

Location *

Title of Workshop *

Your Address Details

Please complete ONE of the following sections :-

Home Address

House Number/Name *

Street *

Area *

County *

Post Code *

Telephone Number *

Business Details

Organisation *

Address *

Telephone Number *

Fax Number

E-mail Address *

Tick the sector you are linked to

Co-operative

Credit Union

Voluntary Sector

Other

If Other, please specify

What services do you provide to your client group? *

Payment Details (Please see Price Bands in Workshop Timetable)

I enclose a cheque for payment *

Do you require an Invoice? *

Please indicate which address an invoice should be sent to

Home

Business

Is your organisation a Credit Union *

Does your organisation have *

Please indicate if you have any specific needs

Dietary

Access

Other

What in particular do you want to learn from this workshop?

Please specify

Further Mailings

I would like training information/future timetables to be sent to my home address

Yes

I would like training information/future timetables to be sent to me at my work address

Yes

How did you hear about the Wales Co-operative Centre’s training workshops?

Please specify *

Cancellation Policy

I have read the Booking and Cancellation Policy, including Data Protection information.

I agree to pay the cancellation fee if I cancel or not attend the workshop as outlined in the Wales Co-operative Centre´s Cancellation Policy.

Please state that you have read, and accept the Data Protection and Booking and Cancellation Policy agreement.

terms and conditions

* indicates a required field