ICC Michael Longley Poetry Course
Check Website for course dates.

Due to the ongoing impact of Covid-19, these classes will be based online. Access to the tutors' online accounts will only be granted on receipt of the course fee.

Privacy: Your data will not be shared with any external agencies and will be seen only by staff and tutors of the Irish Cultural Centre Hammersmith.
Email address *
Name: *
Address:
Date of Birth (dd/mm/yyyy):
Telephone Number: *
Occupation:
Is this your first time participating in the Irish Cultural Centre Education Programme?
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If you answered 'No' to the last question please tell us which class:
Are you Irish Born?* *
*Not a requirement
Are you of Irish descent?* *
*Not a requirement
How did you hear about the centre?
Do you accept the terms and conditions as stated below: *
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I confirm, by signing below, that I have read and accepted the terms and conditions of subscription and participation in the ICCH Ltd Education Programme* and all information given is up to date and correct. *
Please sign by typing name and date.
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The class fee for this term is £60. Please use the following link to make your payment via PayPal:
Alternatively please use the payment button on the relevant class page on our website and select 'pay by credit or debit card' when prompted.

Alternatively, please email william@irishculturalcentre.co.uk who can supply you with the means to pay via online bank transfer. Thank you.
A copy of your responses will be emailed to the address you provided.
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