| (One form per course - if booking more than one
course - please use separate forms)
Course title ………………………………………………………………………………
Date …………………………………………….
No of places required ………..............................
Name/s …………………………………………………………..
Address …………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
……………………………………………………………………………………………
Phone number…………………………………………………………
Email……………………………………………………………………………………..
Non-refundable deposit £10 per person/per
course enclosed. Please make cheques payable to Pam Lewis.
Total amount…………………….
Signed………………………………………………………………..
Date……………………………..
Please return form by post to:
Pam Lewis,
Sticky Wicket, Buckland Newton,
Dorchester, Dorset DT2 7BY
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