JANET Training Booking form

Courses Booking Form

Your Chosen Course
* mandatory fields

Course name	Intoduction to DNS
Course location	Birmingham
Course date	17th November 2010


Your Details


Title:

First name *	as it will appear on badge

Surname *	as it will appear on badge

E-mail *


Job title

Department

Organisation:	as it will appear on badge

Address *



Postcode *

Telephone *

Your Sector *	Higher Education Further Education Specialist Colleges Personal and Community Development (ACL) Research Other

Your Requirements


Dietary requirements:

Any access requirements:	eg hearing loop

If you would like to receive free SMS course updates and reminders please provide the mobile number that messages should be sent to:


Course Fee (including VAT)


	Primary Connected Organisations - £180 Interconnected Sites - £200 Commercial companies supporting JANET sites - £275

Payment Options


Purchase order number:
If a purchase order number is not available at the time of booking, please email the reference to training@ja.net as soon as possible afterwards.

Payment by: *	Invoice Credit card JANET Training Credit

For JANET Training Credit:	Please quote the reference number


For cheques:	Please make payable to "JANET(UK)"

For invoices:	If Invoice address is different to the address given above, please enter details here:
Invoice address:



Postcode:

For credit cards:	JANET Training will contact you for further details. If payment will not be taken from your personal account, please specify a contact name and telephone number.
Contact name:

Telephone: