<p> BOOKING FORM SHORT COURSE / CPD WORKSHOP</p><p>You may book multiple courses using this form If you are arranging a private group session please use the group booking form </p><p>COURSE TITLE DATE NO. TOTAL FEE AMOUNT DISCOUNT CLAIMED PLACES PAID 5% FHT membership REQ [min [supply membership no.] deposit 50.00] 5% Full payment discount ONLY ONE DISCOUNT MAY BE CLAIMED PER BOOKING</p><p> I have read and agree to abide by the booking terms and conditions [copy available online and on request]  I understand that a non- refundable deposit of £50.00 is required to secure my place and that the balance of all fees is due by commencement of training.</p><p> www.lorrainedavistraining.com Tel: 01885 – 488548 Email:[email protected] NAME :</p><p>ADDRESS :</p><p>TEL. No :</p><p>EMAIL:</p><p>ARE YOU SENDING COPIES OF CERTIFICATES YES □ NO □ [If previous qualification certificates are required as a pre-requisite, these must be supplied before qualification can be given]</p><p>DO YOU HAVE ANY SPECIAL DIETARY REQUIREMENTS?</p><p>PLEASE LET US KNOW  IF YOU HAVE A DISABILITY THAT WE NEED TO BE AWARE OF: YES □ NO □ IF YES DETAILS: </p><p> IF YOU ARE PREGNANT: YES □ NO □</p><p> IF YOU ARE TAKING MEDICATION: YES □ NO □</p><p>SIGNATURE: DATE : ALL INFORMATION SUPPLIED IS CONFIDENTIAL</p><p> Please make cheques payable to L. Davis  A receipt will be sent to you by post or email to confirm your booking [a hard copy receipt for fees will be provided when you attend your course]  A confirmation letter will be sent to you with your receipt giving full details of venue, directions, and course requirements on receipt of your booking form and deposit.  If you will be unable to attend your course please let us know as soon as you can. Please see cancellations policy.</p><p>Please return this form online, by email or post :</p><p>Post to :Lorraine Davis Holistic Healthcare and Education Centre, Pike House, Edwyn Ralph, Bromyard, Herefordshire, HR7 4LT</p><p> www.lorrainedavistraining.com Tel: 01885 – 488548 Email:[email protected] Email: [email protected]</p><p>You can complete this form online at : www.lorrainedavistraining.co.uk We look forward to meeting you – if you have any queries before your course starts please feel free to contact us – we are here to help! Tel: 01885 – 488548 Email:[email protected]</p><p> www.lorrainedavistraining.com Tel: 01885 – 488548 Email:[email protected]</p>