Booking Form

Application Form

Please enter your details in the spaces provided below. Then print the form and send to:

Debra G Goldston, Clear Intentions Holistic Training Solutions Ltd, Hildon Villa, Pooley Lane, Moreton, Nr Newport, Shropshire TF10 9DU

Course title, Venue & Date:	Patrick Ziegler's All Love Workshop - 21st & 22nd June 2008
Name:
Address:
Telephone/ Mobile:
Email:
Date of birth:
I confirm that I have read and understood and am happy to accept the Booking Terms and Conditions (available by clicking here).
Signed:
Print name:
Date:

Deposit only: £70

Full fee: £333

I enclose a cheque for £ made payable to Debra Goldston