Booking Form
 
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Please complete in Block Capitals and post to:
Dr. A. J. Hughes, 8 Birchwood Road, Malvern, Worcs., WR14 1LD
 
Organisation:  ...............................................................................................................
Contact Name:  ......................................................... Phone  .......................................
e-mail address:  ............................................................................................................
Address:  ....................................................................................................................
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...................................................................................Post Code................................

Date of Lecture:  .........................................  Time Hall is Opened  ..............................
Lecture Start Time:  .......................................  Duration  ............................................
Address of Lecture Hall:  ............................................................................................
Car Parking arrangements  ..........................................................................................

Lecture Subject:  ........................................................................................................
Expected size of Audience (approximately)  .......................

I understand that the Lecture Fee will be:
     50p per person present  PLUS  20p per mile (round trip)  PLUS  £15 

Signed: ..............................................................

Anything else?  ..........................................................................................................
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