First Name:
Surname:
Address:
 
 
Postcode:
Telephone:
Please book me on to the course:
Date from: Date to:  
Type of room required:
Special Diet:
Payment  
Cost for persons participating: £
Cost for companions: £
Total Cost: £
Remittance: £
Deposit (1/3 cost of course): £

The balance is due one month before the course starts.

I enclose a cheque for the booking deposit/full payment (made payable to The Wye Valley Arts Centre Ltd.) and will pay the balance due at the appropriate time.

I declare that I am over 18 years of age and I fully accept and will abide by the booking conditions.
Date:
Signature:

Please state where you heard of the Wye Valley Arts Centre:
If you would like a brochure with details of all our courses please tick here


Please fill in the form, print it out (ctrl-P) and send with your cheque (made payable to The Wye Valley Arts Centre) to:

The Wye Valley Arts Centre
The Coach House
Mork
St. Briavel's
Lydney
Gloucestershire
GL15 6QH

  Member of the Adult Residential Colleges Association

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