Stroke CARE :: Tauranga area :: July 2017
Course Booking Form - Papamoa Community Centre - Tuesday 18th July
Email address *
Your Name *
Your answer
Name of workplace / employer (or family carer) *
Your answer
Address *
Your answer
Mobile number *
Your answer
Your Role *
Do you have any special requirements? (e.g. dietary, accessibility...)
Your answer
Terms: *
Terms and conditions of booking:
REFUNDS: No refunds will be given for cancellations. Substitution of participants is acceptable at any time prior to the course commencing - please inform tutor by email.
Course fees payable: *
(Earlybird closed 30 June)
Payment of course fees *
Employer contact details if invoicing employer
Your answer
How did you hear about the course?
Any questions or comments?
Your answer
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy