Booking a course with Active First Aid

Please complete the following booking form and follow with your payment. Or print the form and send by post. Alternatively please send an invoice contact name, address, and if necessary a purchase order number. For payment details please see below.

Course Name

Course Date

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

(###)

###

####

STUDENTS (If not applicable, please leave blank)

NAME OF SCHOOL, COLLEGE OR UNIVERSITY:

ADDITIONAL INFORMATION (Applicable to 2 day emergency course only)

DO YOU REQUIRE ACCOMMODATION DETAILS

Yes

No

PAYMENT

Please confirm the amount paying:

(Please tick relevant box)

CHEQUE* Please make cheques payable to K A Wills

BACS HSBC Sort Code: 40-09-03 A/C 11627619

Paying by Invoice Address

PO Number (If required)

Email address to send invoice

* Please put your name and the date of the course on the back of all cheques. Completion of this booking form is an acknowledgement that you have read and agree with the terms and conditions of Active First Aid Training.

I acknowledge that I have read Active First Aids Terms and Conditions