UNDERSTANDING HEALTH IMPROVEMENT BOOKING FORM

Please use block capitals to complete

Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Organisation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

 Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   Post code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Contact person (for booking enquires) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Telephone . . . . . . . . . . . . . . . . . . . . . . . . . . .   Email . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Registrations will be confirmed and final programme for the day with travel directions will be sent by email.

Numbers are limited to enhance learning

Please register the following person(s) to attend the Understanding Health Improvement Level 2 (block capitals)

Please advise of any special dietary requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Payment of £150 per person to be made:

• by cheque made payable to ‘Beth Gibb Associates' for the sum of £ . . . . . . . . . . . . . . . . .
• by invoice against a purchase order number / ref . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Invoices should be settled within 30 days  

Booking Terms and Conditions  

•   Confirmation of reservation(s) for course will be sent via email after training event fee has been received.

•   We reserve the right the right to refuse entry to any delegate who has not paid prior to attending the course.

•  A refund will not be made fewer than 14 days before the course date.  75% of the course fee will be reimbursed up to 14 days prior to the course date.

•   Cancellations must be received in writing at least 14 days before the course date.  if a named individual cannot attend, a substitute delegate may be used and the name changed on the day.

•  Reductions apply to ‘in house' courses, registered charities and not-for-profit organisations.  details can be given on request

I agree to these terms and conditions

Name (print):  . . . . . . . . . . . . . . . . . . . . . . . . .   Signature: . . . . . . . . . . . . . . . . . . .

Organisation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Date: . . . . . . . . . . . . . . . .

Completed applications should be returned with fee or Purchase Order number to:

Post: 6 Kenilworth Park, Lisburn, Co. Antrim, BT28 3UL

Email: info@bethgibbassociates.co.uk 

Fax: 07092 859647