Booking Form - (Derbyshire courses only)

Please print out a copy of this form, complete your details and POST to:
Zantium Studios, Godfrey Hole House, Hopton, Wirksworth, Derbyshire, DE4 4DF

*** enclosing your deposit *** (cheques payable to: Zantium Studios Ltd)

Your Contact Details
Name
Address including postcode
Phone no. (daytime)		Phone no. (evening)
e-mail address

Course Details
Course title
Course dates
Dietary requirements

Accommodation Details
Would you like to book accomodation at Godfrey Hole House?						Yes No
Arrival date		Departure date		Total no of nights
Please note these are your required accommodation dates rather than the course dates

How did you hear about Zantium Studios?
Would you like to be on our mailing list? (Course details sent out about twice a year)	Yes No
Do you accept the Terms and Conditions?	Yes No
Signature