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"Decade of Destiny" Booking Form
1. EVENT / SEMINAR / WORKSHOP DETAILS
Event Title
*
Date
*
2. YOUR PERSONAL DETAILS
Title
Miss
Mrs
Ms
Mr
Name
*
Surname
Address Line 1
*
Address Line 2
*
Town
*
City
*
Post Code
*
Daytime Telephone
*
Mobile Number
*
Email Address
*
Dietary Preferences
None
Vegetarian
Vegan
Other
Food allergies/ Special requirements
Please state any accessibility and/or special needs:
Is there anything else you would like us to know or be aware of?
I would like to receive information about other CLM events.
3. RESIDENTIAL / ACCOMMODATION PREFERENCE (Please tick your preference)
Accommodation Preference
Single (En-suite)
Single (Standard)
Twin (En-suite) – With someone you know
Twin (Standard) – With someone you know
Family Room/Dormitory – With someone you know
Family Room/Dormitory – Room share allocation on arrival
Individuals who wish to attend both days of the retreat, but who do not require accommodation, or in the case where accommodation is over subscribed, then please contact us and we will be able to offer you a ‘Non-residential Weekend Rate’.
Non-Residential Delegate
5. PAYMENT DETAILS
We appreciate receiving booking before events, particularly if you would like an en-suite room. Please enclose a non-refundable deposit of £30 for each adult, the balance is payable prior to the start of the event. Payment can be made by BACS (using your name as the reference) or by cheque in the post (please put your name & address on the back of the cheque).
In the case of cheques please make all cheques payable to:
“Christian Leadership Ministries”
Please send your Booking Form and Accommodation Request to:
Bookings
Christian Leadership Ministries
Fairgate House
205 Kings Road
Tyseley
Birmingham B11 2AA
Payment by BACS:
Bank Name:
The co-operative bank
Sort Code:
089299
Account Number:
65622012
6. MARKETING INFORMATION (please tick)
I heard about this event by:
Recommendation
Flyer
Web search
Church
Other
If Other, Please Specify
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