Please print this form and send it with your
deposit/payment to:
Peter Delves Associates, 39 Randall Road, Kenilworth, Warwickshire CV8 1JX.
Booking with confidence! If you are unable to attend the course, the deposit amount can be transferred to another course. Any fees above the deposit that have been paid will be refunded.
FULL NAME & TITLE
NAME YOU PREFER TO BE CALLED
ADDRESS
POSTCODE BUSINESS TEL HOME TEL
E-MAIL ADDRESS DATE OF BIRTH
PRESENT OCCUPATION
WHICH COURSE DO YOU WANT TO ENROL FOR ? (Location & Start Date).
WHERE DID YOU HEAR OF THIS COURSE?
REASONS FOR WISHING TO TAKE THIS COURSE
I ENCLOSE:
Cheques to be made payable to "Peter Delves".
Deposit of OR The full fee of....
Signed
..
Date