Booking Form - Annual Conference, Horsleys Green, May 2013

Information about you

Your name:

Partner's name (Please leave blank if not applicable):

Your postal address (including the post code, please):

Your telephone number:

Your email address:

Details of accommodation and meals

I/We shall be attending:

If you are attending as a day visitor only, please skip the remaining questions about accommodation and go directly to the question about meals.

I/We would like to have:

I/We would like:

Some superior rooms only have facilities for disabled people or are on the ground floor. Please indicate if you wish to have either or both of these facilities.

Additional Facilities:

Disabled Facilities

Ground Floor

If you have booked accommodation, all your meals are included and you should ignore the next question, please. For those attending as day visitors on one or more days, meals may be purchased on Saturday and Sunday. Please indicate which meals you will require.

I/We shall require the following meals:

Special dietary requirements:

Other information

I can help with music as follows:

I can help with transport. (Please indicate where you will be travelling from and how many people - with luggage - you can assist.)

A deposit of at least £20 per person is required with the booking form, please. Cheques should be made payable to MissionAssist and sent to PO Box 257, Evesham, WR11 9AW, with a short note giving your name and indicating that the cheque is for the annual conference, 2013. Alternatively, payment may be made by direct bank transfer to our account at CAF Bank, Account Number: 00013028, Sort Code: 40-52-40. Please indicate below how you will be paying. Thank you!

I shall be paying as follows:

A deposit only,

by cheque

by bank transfer

Please tick the box if you would like a copy of this form sent back to you.

Copy of form to me, please.