Pyramid Educational Consultants UK Ltd

PECS Workshop Application Form

 

Please print out, complete and return separate forms for each applicant together with payment to:

Pyramid Educational Consultants UK Ltd, Pavilion House, 6 Old Steine, Brighton, BN1 1EJ

Tel: 44 (0)1273 609555 Fax No: 44 (0)1273 609556

 

VAT no 750212181

 

 

Workshop Dates                                                               Location

First Name                                                                         Surname

Organisation (if applicable)

Address

 

Postcode                                                                           Tel

Occupation (eg parent, teacher, psychologist)

Email Address

Please tick the box if you do NOT want to receive information and regular updates from us

 

Let us know if you have any special dietary requirements

 

Payment (MUST be received before the date of the workshop)

Confirmation of your place will be sent on receipt of payment.  Please select a method of
payment from the options below (tick the grey box).

 

Cancellation Policy
We regret that delegate cancellations made less than six weeks in advance of the workshop cannot
be refunded. Cancellations must be made in writing and sent to the Pyramid office.

 

 

Please make payable to Pyramid Educational Consultants UK Ltd

 

Please invoice my organisation £

 

Approving Manager

Purchase Order No. (please attach order)

Organisation Name and Address

                                             

Tel:

 

 

I wish to pay by credit/debit card I authorise you to debit my account

 

Name on card

Card no

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Card issue No: (if applicable)

Card valid from date: (mm/yy)

Card security code: (last 3 digits on back of card near signature)

                                                                                           Expiry date

 

 

 

 

 

Cardholder’s address (as on statement)

 

 

 


Cardholder’s Signature