Please complete this form to make bookings for courses and/or workshops, copy and paste into an email, or print it and send it though to us with your payment method details. (Please be aware that BACS or internet banking payments can be made on request with completed booking form).

COURSE/WORKSHOP BOOKING FORM

Name:
Name
Organisation Name
Organisation Name (if applicable)
Finance/HR Contact Name
If your organisation is funding your course/workshop please provide the finance/HR contact name and telephone number
Address
Please provide address where the booking confirmation and other correspondence will be sent.
Your Telephone Number
Please provide both landline and mobile where we can contact you with course/workshop information.
Your Email:
Email
Course/Workshop Selection
Please select one of the above.
Course Dates.
Please provide all of the dates of the course/workshop you wish to attend.
Course Location
Description (click to edit)
Special Dietary Requirements
Please provide as much detail as possible and we will endeavour to do our best to cater to your needs. If you are booking for a group please provide the number of people with each of the different dietary requirements you are ordering e.g. 3 x vegan.
Religious/Spiritual needs
Please provide as much detail as possible and we will endeavour to do our best to cater to your needs. If you are booking for a group please provide the number of people with each of the different religious/spiritual requirements
Communication Requirements
E.G. Deaf interpreter, Welsh or other language interpreter. Please contact Symbiotic and Sustainable Systems as there may be an additional fee for these services if not part of the standard course or group package.
Personal Assistance & Support Requirements
E.G. Wheelchair access required, medical conditions requiring specific needs - please provide as much details as possible and we will endeavour to do our best to cater to your needs.
Data Protection
Your information will be used for Symbiotic and Sustainable Systems purposes only. Your details will not be released to third parties, or used for any purpose not related to Symbiotic and Sustainable Systems activities. Data held by Symbiotic and Sustainable Systems is subject to the provisions of the Data Protection Act 1998.
E-List and Mailing List
Yes
I have already subscribed
No thanks, not at this time
Would you like to go on the Symbiotic and Sustainable Systems mailing list to receive news of forthcoming courses, workshops and events?
How did you hear about Symbiotic and Sustainable Systems?
Word of Mouth/Recommedation
Printed Media e.g. Newspaper
Flyer/Leaflet
Networking event
Display or Presentation
Other
Description (click to edit)
If Other, please provide details.
Description (click to edit)

Course/Workshop Fees and Payment Details

Booking Type
Please note: All fees quoted are for a two day course. For longer courses please contact Symbiotic and Sustainable Systems directly for quote.
Terms and Conditions
50% non-refundable deposit required at time of booking or no later than 8 weeks prior to course commencement date. Final 50% balance required on receipt of invoice and no later than two weeks post-completion of course/workshop unless otherwise stated.
Payment Method
Cheque (made payable to Dr. K. Polistina trading as Symbiotic and Sustainable Systems and sent to Course Bookings, Symbiotic and Sustainable Systems, P.O. Box 83, M/T WALES CF477BE)
Internet Banking or BACS please contact us for bank account details
Invoice (Invoice payments to approved companies only.  Terms and conditions - Full Payment required within 14 days of course completion).

Office Use Only

Booking confirmation date
Description (click to edit)
Booking Confirmed Number __________
Yes 50% deposit Receipt No. ____________ on ____/____/____
No still awaiting deposit - Due Date ____/____/____
Description (click to edit)
Invoice Generated Number ___________
Yes on ____/____/____
No
Description (click to edit)
50% Dep Payment Recd
Yes Receipt No. _______________ on ____/____/____
No Due Date ____/____/____
Description (click to edit)
50% Balance Payment Recd
Yes Receipt No. _________________ on ____/____/____
No - Due Date ____/____/____
Description (click to edit)
Enter the code below in here: