1.    Which workshop would you like to attend?                                         

      

Course	Course Fee	Date	Yes/No
Discover Your Angels & Guides	R1,950.00 - Whereby a percentage (%) of your investment will be donated to charity	3-26 July 06 (8 evenings) 15-16 July 06 (1 weekend)

      

2     Please supply your contact information               

      

Last Name
First Name
Postal Address
Postal Code
Telephone (Landline)	(      )
Fax Number
Cell Number
E-Mail Address

                                                                                                           

      

3     Do you wish to make bookings for additional persons YES/NO (Delete as applicable)

      

If you wish to include additional persons in this booking please supply the following information.

                                                                                   

Additional Person 1
Last Name
First Name
Contact Tel. Number
E-Mail Address
Additional Person 2
Last Name
First Name
Contact Tel. Number
E-Mail Address

 

 

4     Payment Options                                                  

        

Options	Yes/No
Bank Deposit
Internet Transfer
Cash Cheque
Credit Card – Straight or Budget

      

4a.  Mind Body Spirit Banking Details                                                                            

      

To secure your booking please pay the minimum required deposit of 50% of total course price.  The final balance of the course is payable before the start of the particular course date.

      

Bank Account details
Account Name	Falcon Crossing
Bank	Standard Bank
Branch	Orange Grove
Branch Code	00-41-05
Account Number	20-162-547-4

      

                                                                                                                                                    

4b.  I wish to pay using my credit card                                                                         

      

Online payment by credit card is not available – unless it has been setup by your bank. To make payment by credit card, please supply the details requested hereunder. Unfortunately Diners Club and American Express cards cannot be accepted.

                                                                                   

If this payment option is chosen your credit card will be debited with the deposit amount due upon receipt of your completed booking form. An invoice and statement will be emailed or faxed to you showing the deposit received. Unless otherwise requested, the balance due will automatically be debited to you credit card at the start of the particular course you are attending.

                                                                                   

Credit card budget facilities are available. If this option is used, the entire workshop payment will be debited to your card on receipt of your completed booking form.

                                                                                   

If budget payment is required, indicate number of months                                               

      

Please supply following information if paying by credit card                                 

      

Credit Card Details
Card Type eg. MasterCard, Visa.
Card-Holders name as it appears on card
Credit Card Number
Expiry Date of card
CVC Number (3 digits on back of card)

        

      

Thank you for your booking

Kind Regards

Heather Botha - 082-428-9211