BOOKING FORM
To reserve a place, contact me on phone/fax 01904 646282, email moss@dircon.co.uk
or print out and fill in and return this form to:
Jean Moss, 17 Clifton Dale, York YO30 6LJ

Name........................................................................................................... Address............................................................................................................

.....................................................................................................................................................................................................................................................

Phone.......................................................................................................... Email.................................................................................................................

Course(s).................................................................................................... Date of Course(s)........................................................................................

I enclose cheque for the amount of £...................

OR you may debit my credit card £....................... Card No..............................................................................Expiry date........../..........

Name on card............................................................Signed................................................................................Date.........../............/...........