<p> EDTNA / ERCA </p><p>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]</p><p>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</p><p>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</p><p>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</p><p>Sunday only M MEMBERS RATE £60 £85 N NON-MEMBERS RATE £95 £120 O plus Full membership of EDTNA/ERCA £120 £145</p><p>Monday only Q MEMBERS RATE £60 £85 R NON-MEMBERS RATE £95 £120 S plus Full membership of EDTNA/ERCA £120 £145</p><p>All rates include lunch **Saturday night accommodation does not include an evening meal but there is a restaurant within the hotel. EDTNA / ERCA TITLE:-</p><p>FORENAME:-</p><p>SURNAME:-</p><p>TRUST / COMPANY:-</p><p>JOB TITLE:-</p><p>PLACE OF WORK:-</p><p>ROAD:-</p><p>TOWN / CITY:-</p><p>POSTCODE:-</p><p>CONTACT PHONE NUMBER:-</p><p>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.</p><p>**For BACS payments: Please include your surname in your reference.</p><p>National Westminster Bank Sort Code: 60-12-02 Account Number: 14039680 IBAN:- GB22 NWBK 6012 0214 0396 80 SWIFT/BIC:- NWBKGB2L</p><p>Unfortunately we are unable to process payments by credit card.</p><p>For booking enquiries please email [email protected]</p><p>Please PRINT CLEARLY when completing your application form</p>