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East Anglia Centre

Open Meeting & AGM 27th April 2006

'Waste of Life and Limb'


Booking Form and Online Payment
(Items in RED are required items)

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Full Name

Company

Address
Town
County
Post Code
Daytime Contact No
Email
Delegate Details

Please choose from the following options:-

CIWM Members £20.00 including lunch

Student members £10.00 including lunch

Non CIWM members £30.00 including lunch
Attendance at AGM only (no lunch or open meeting) £FREE
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No. of Delegates:

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Payment Details

Please tick this box if you require a VAT receipt
Registered VAT no 232800302
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Payment Method:

If paying by cheque, please send us your cheque upon receipt of your invoice.
If paying by card, please complete the following details:

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Cardholder's Name:
Card No:
Expiry Date

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