Booking Form

I wish to book onto the following Course/Workshop:

Reiki Mastership Update - Athena - 27th & 28th July 2007

1. Please provide the following information:
Name:
Address:
Telephone/Mobile:
Fax/Email:
Date of Birth:
Please state if you have any disabilities or conditions which may require any special help during the course/workshop:
Please state how you heard about the course:
One day only: £50		Both days: £100
2. Please select your method of payment:
2. Please select your method of payment: Cash (paid in person) Cheque PayPal Credit/Debit Card Deposit only and balance in instalments by Standing Order Mandate (programmes only).

If paying by Cheque: I enclose a cheque for £ made payable to Clear Intentions.

If paying by PayPal:
Please print this form before clicking on the relevant PayPal button below to make your payment. We will still require a completed and signed Application Form to process your booking. Please note that a payment made via PayPal also forms acceptance of the Booking Terms and Conditions explained below.

Please state PayPal transaction ID:

If paying by instalments (programmes only):
We will require a deposit to secure your place on the course. To pay the balance by instalments please click here to download a copy of the Standing Order Mandate form, complete and send it with your completed and signed Application Form. There is no charge for paying by instalments.

3. Please sign and date: I confirm that I have read and understood the Booking Terms and Conditions (available by clicking here).

Signed:

Print name:

Date:

4. Please print the form and hand/post to: Debra G Goldston, Clear Intentions Holistic Training Solutions Limited, Studio 101, Sunbeam Studios, Sunbeam Street, Wolverhampton, WV2 4PF

Once we receive your signed application form for a course/workshop we will send you an induction pack and instructions on how to pay the balance if the deposit only has been paid.