Course Title*

Course Dates*

Name Of Delegate*

Company or Organisation

Position

Address for delivery of pre course package*

Postcode

Invoice Address (if different)

Postcode

Your Purchase Order No. (if used)

Email

Telephone*

Payment Details

Total Cost

Please select as appropriate*

Please Select... Please invoice me for the full course fee Please invoice me for the non-refundable deposit

Please indicate lunch requirements*

Please Select... Vegetarian Option Non Vegetarian Option

Any other special requirements?

Do you require details of hotel accommodation in Manchester?

Date

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*

*The non-refundable deposit is 20% of the course fee. All fees for courses are due before the start of the course. * Required information.

Before you send the form, print a copy of your registration form to keep.

If you would like to print out the form and post it, please
download here and send it to:

Stuart Robertson & Associates Ltd, Empress Buildings,
380 Chester Road, Manchester M16 9EA

Or fax to: 0161-877 4500