EDTNA / ERCA

Please select the Package code you require and fill in the attached Before After booking form and email it c/o Linsey Worsey:- 30.09.17 30.09.17 [email protected]

Saturday and Sunday night accommodation, including breakfast. Gala dinner (Sunday evening) and seminar fees.** A MEMBERS RATE £285 £335 B NON-MEMBERS RATE £365 £415 C plus Full membership of EDTNA/ERCA £355 £405

Sunday night accommodation, including breakfast. Gala dinner (Sunday evening) and seminar fees. E MEMBERS RATE £195 £245 F NON-MEMBERS RATE £275 £325 G plus Full membership of EDTNA/ERCA £265 £315

Sunday and Monday without accommodation I MEMBERS RATE £95 £145 J NON-MEMBERS RATE £175 £225 K plus Full membership of EDTNA/ERCA £165 £215

Sunday only M MEMBERS RATE £60 £85 N NON-MEMBERS RATE £95 £120 O plus Full membership of EDTNA/ERCA £120 £145

Monday only Q MEMBERS RATE £60 £85 R NON-MEMBERS RATE £95 £120 S plus Full membership of EDTNA/ERCA £120 £145

All rates include lunch **Saturday night accommodation does not include an evening meal but there is a restaurant within the hotel. EDTNA / ERCA TITLE:-

FORENAME:-

SURNAME:-

TRUST / COMPANY:-

JOB TITLE:-

PLACE OF WORK:-

ROAD:-

TOWN / CITY:-

POSTCODE:-

CONTACT PHONE NUMBER:-

EMAIL:- (This will be used to confirm your booking and to give you further information.) EDTNA/ERCA MEMBERSHIP NUMBER:- (required for members’ rates) PACKAGE CODE:- (A-T see reverse of this form) COST:- NHS Trust / Other – Trust Charitable Funds METHOD OF PAYMENT:- Personal Cheque Number *:- BACS ref **:- SPECIAL DIETARY REQUIREMENTS OTHER SPECIAL REQUIREMENTS *Cheques should be made payable to EDTNA/ERCA UK.

**For BACS payments: Please include your surname in your reference.

National Westminster Bank Sort Code: 60-12-02 Account Number: 14039680 IBAN:- GB22 NWBK 6012 0214 0396 80 SWIFT/BIC:- NWBKGB2L

Unfortunately we are unable to process payments by credit card.

For booking enquiries please email [email protected]

Please PRINT CLEARLY when completing your application form