| Breathworks - Ely Workshop Booking Form |
 |
 |
|
Workshop for Health Professionals, Wednesday 6th and Thursday 7th October 2010 at Ely Cathedral (Please print and complete the form) Please book a place for me on the Introduction to Mindfulness Workshop, Wednesday 6th and Thursday 7th October 2010 at Ely Cathedral (You can also book with a credit or debit card by telephone, 0161 834 1110) Price £250 (incl VAT) (if paid for by institution or company) Name .………………………………………………………………………. Address ………………………………………………………………………. Job title……………………………………………………………………….. Email ……..………………………………………………………………….. Telephone .………………………………………………………………….. Mobile ……………………………………………………………………….. How did you hear of this event ………..……………………………………… I will be paying the full amount of £ I enclose a cheque for £60 deposit £ Balance due one month before event: £ OR I enclose a cheque for the full amount £ Please make cheques out to Breathworks and send with booking form to: Special requirements? Please note any additional requirements on reverse of this form, such as special dietary requirements for lunch |