E-Learning Booking Form

Booking Form – E-learning

Please complete the Booking Form below and click the ‘Send’ button at the bottom of the form

Company Name *

Please enter the name of your Company or Organisation

Course to be allocated & Number of Credits *

Please confirm the title of the course you are booking and how many credits this requires

Total Number of Credits *

Please tell us the number of Credits you are purchasing with this booking

Booking Contact's Name *

First

Last

Please provide the name of the contact for this booking

Booking Contact's Position *

Please confirm the position of of the Contact in your organisation

Booking Contact's Email

Please confirm the main contact person's email address

Booking Contact's Phone *

Please confirm the main contact person's phone number

Invoice & Billing

Invoicing Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Accounts Email *

Total Order Value £ *

Please confirm the monetary value of your booking here

Purchase Order Number

If you have raised a Purchase Order - please enter the PO number here

And Finally

Comments or Message

Signature (Touch Screen or Mouse)

Using either a touch screen or your computer's mouse - please sign here to agree to the terms and conditions outlined below

Signatory's Name *

First

Last

Please confirm the name of the signatory and in doing so that they are authorised by the company or organisation to submit this booking

Phone

Cancellation Arrangements:

Notice of cancellation is required in writing.

Telephone cancellations will be accepted but be confirmed in writing within seven (7) days. Substitution of delegates will incur no charge.

The amount of the course fee that is still applicable will be determined as standard according to the following rules:

Cancellation Notice	Fee Payable:	If transferred to later date:
No Show	FULL	FULL
5 days or less	FULL	FULL
6 to 10 days	75%	50%
11 to 15 days	50%	25%
16 to 20 days	25%	10%

For NEBOSH and IEMA Courses:

Cancellation Notice	Registration Fees Payable:	If transferred to later date:
30 days or less	FULL	FULL
	N.B. Days = Working Days

Upon receipt of completed Booking Form an Invoice and Course Joining Instructions will be issued.

Booking Form – E-learning

Invoice & Billing

And Finally

Cancellation Arrangements:

TERMS:- STRICTLY 30 DAYS NET FROM INVOICE DATE (unless otherwise agreed)

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