<p>Course title Venue Date Cost £</p><p>Total:</p><p>Name:</p><p>Address:</p><p>Postcode:</p><p>Telephone: Mobile:</p><p>Email:</p><p>Payment: Please make cheques payable to Tŷ Elis (Porthcawl Counselling Service) or a BACS transfer details on request.</p><p>Please note: For all fee paying courses, your booking cannot be accepted unless it is accompanied by full payment. </p><p>Additional Requirements: Please contact us if you have any special requirements for the course.</p><p>I have specific additional requirements as follows: Please Specify</p><p>Please return to: Val Davies, Administrator, Tŷ Elis (Porthcawl Counselling Service, 14 Victoria Avenue, Porthcawl CF36 3HG or e-mail: [email protected]</p><p>Tel: 01656 786486 Registered Charity Number: 1098986 Company No. 4756994 www.tyelis.org.uk</p>