"Decade of Destiny" Booking Form : Christian Leadership Ministries

1. EVENT / SEMINAR / WORKSHOP DETAILS

Event Title

*

Date

*

2. YOUR PERSONAL DETAILS

Title

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.

Your details will not be passed on to any 3rd party companies.

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

"Decade of Destiny" Booking Form

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