Date: 11/11/08
Time: 09:30 - 16:00
Venue: MDDA, Manchester, M1 6ED
Name:
Job Title:
Organisation Name:
Address: Please enter details
Postcode:
Telephone:
Personal E-Mail:
Membership No. (if appropriate):
Project Name:
Brief Project Description:
Do you have any specific dietary requirements?
Do you have any accessibility requirements?
Please tell us where you heard about this event
Organisation type, sector and no. of employees
What do you hope to achieve from the course
Please choose appropriate payment cost:
1. Member organisations with less than 5 staff £105.75
2. Organisations with less than 5 staff £117.50
3. Member organisations with less than 15 staff £141.00
4. Organisations with less than 15 staff £152.75
5. Member organisations with more than 15 staff £176.25
6. Organisations with more than 15 staff £188.00
7. Member commercial and private sector organisations £235.00
8. Commercial and private sector organisations £246.75
Online (by credit/debit card)
Invoice
Cheque and BACS
Please enter invoice details if different from your own. We will send out an invoice by post within 7 days of receipt of this form. Invoice to be sent to:
Invoice Address:
I have read and agree to the terms and conditions below:
