Medical Booking Form (Cheque)

* this is a required field

Personal Details -

Name*

Company

Address Line 1

Address Line 2

Town

County

Postcode

Landline Tel No.*

Mobile Tel No.*

Email Address*

How did you hear about us?

First Aid Course -

Select First Aid Course*

Select Course Date*

Number of people in group*

Admin -

Please remember to add VAT to all course costs. Make cheques payable to "Expedition Wise Ltd" and send to: Expedition Wise Ltd, Unit 4 Plas Pentwyn, Coedpoeth, Wrexham. LL11 3NU. Please add your name and course date to the rear of the cheque.

If you wish to pay by BACS, please write "BACS" in the comments box below. BACS details are: Sort Code: 72-00-06; Account Number: 53618484. Please remember to put your name as an identifier on the BACS payment.

Comments

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Medical Terms and Conditions

I Have Read And Agree With The Terms And Conditions