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Booking Form for Booth VRT Courses Do not use this form if the phone number of the organiser is given next to the course on the list of courses, see booking details on previous page. Title: ____ First Name :______________ Surname: _______________________ Address: ____________________________________________________________ _____________________County: _________________Post Code:_____________ Phone Number: ________________email address: _________________________ Course Required : Venue :______________Date: _______________ Basic/Adv/Other(circle) For VRT Basic Courses enter your Reflexology
qualification: _____________________ Remember: if you have already attended a VRT course you are eligible to join the VRT Membership Network and receive a discount on subsequent courses. You may join the Network at the same time as applying for another course. See page on membership for details I wish to apply for my discount: Enter Membership Number
or 'new' if applying for membership now No: ________ I enclose a non-returnable full deposit cheque for £50 per day payable by cheque as shown on the previous page (balance less discount due on the day as cash or cheque). For courses organised by Lynne Booth only you may pay by
credit card if you wish ( please write clearly): |