Please complete a separate form for each course you wish to attend.
Personal Details
TITLE
Mr
Mrs
Miss
Ms
FIRST NAME
SURNAME
ADDRESS
TOWN
POSTCODE
TELEPHONE
MOBILE
EMAIL
Do you have any special requirements?
Employment details (If applicable)
Course Details
Four day Instructor Course
Date - please select
14 / 15 / 21 / 22 September 2010 (Wolverhampton)
12 / 13 / 19 / 20 October 2010 (Wolverhampton)
26 / 27 / 28 / 29 October (Half term) 2010 (Aldersley High School, Wolverhampton)
16 / 17 / 23 / 24 November 2010 (Wolverhampton)
7 / 8 / 9 / 10 December 2010 (Aldersley High School, Wolverhampton)
11 / 12 / 18 / 19 January 2011 (Aldersley High School, Wolverhampton)
8 / 9 / 15 / 16 February 2011 (Aldersley High School, Wolverhampton)
14 / 15 / 17 / 18 February 2011 (Birmingham (Billesley Tennis Centre))
15 / 16 / 22 / 23 March 2011 (Aldersley High School, Wolverhampton)
Assistant Instructor Course
Date - please select
21 / 22 October 2010 (Birmingham (Billesley Tennis Centre))
Instructor Trainer Training Course
Date - please select
Special Educational Needs
Date - please select
16 June 2010 (Wolverhampton)
First Aid
Date - please select
11 October 2010 (Aldersley High School, Wolverhampton)
25 / 26 (evenings 6-9pm) October 2010 (Aldersley High School, Wolverhampton)
8 November 2010 (Aldersley High School, Wolverhampton)
22 / 23 (evenings 6-9pm) November 2010 (Aldersley High School, Wolverhampton)
6 December 2010 (Aldersley High School, Wolverhampton)
13 / 14 (Evenings 6-9pm) December 2010 (Aldersley High School, Wolverhampton)
17 January 2011 (Aldersley High School, Wolverhampton)
24 / 25 (Evening 6-9pm) January 2011 (Aldersley High School, Wolverhampton)
7 February 2011 (Aldersley High School, Wolverhampton)
14 / 15 (Evenings 6-9pm) February 2011 (Aldersley High School, Wolverhampton)
7 March 2011 (Aldersley High School, Wolverhampton)
14 / 15 (Evenings 6-9pm) March 2011 (Aldersley High School, Wolverhampton)
Off Road Training
Date - please select
23 / 24 September 2010 (Aldersley High School, Wolverhampton)
9 October (Fast Track) 2010 (Aldersley High School, Wolverhampton)
11 / 12 November 2010 (Aldersley High School, Wolverhampton)
4 December (Fast Track) 2010 (Aldersley High School, Wolverhampton)
20 / 21 January 2011 (Aldersley High School, Wolverhampton)
21 February (Fast Track) 2011 (Aldersley High School, Wolverhampton)
24 / 25 March 2011 (Aldersley High School, Wolverhampton)
Cycle Maintenance Level 1
Date - please select
12 July 2010 (Wolverhampton (Aldersley High School))
6 August 2010 (Aldersley High School, Wolverhampton)
23 August 2010 (Aldersley High School, Wolverhampton)
20 September 2010 (Wolverhampton (Aldersley High School))
18 October 2010 (Wolverhampton (Aldersley High School))
22 November 2010 (Wolverhampton (Aldersley High School))
13 December 2010 (Aldersley High School, Wolverhampton)
10 January 2011 (Aldersley High School, Wolverhampton)
24 January 2011 (Aldersley High School, Wolverhampton)
14 February 2011 (Aldersley High School, Wolverhampton)
28 February 2011 (Aldersley High School, Wolverhampton)
14 March 2011 (Aldersley High School, Wolverhampton)
28 March 2011 (Aldersley High School, Wolverhampton)
Cycle Maintenance Level 2
Date - please select
28 / 29 October 2010 (Aldersley High School, Wolverhampton)
27 / 28 January 2011 (Aldersley High School, Wolverhampton)
31 March / 1 April March 2011 (Aldersley High School, Wolverhampton)
Costs
Once we receive your provisional booking request we will contact you regarding costs and the availability of any bursaries/funding. At this time we will also discuss deposits and how to pay. Until such time your booking is not confirmed. Once payment is secured full confirmation will be sent.
Purchase Order Number (If applicable)
I HAVE READ AND UNDERSTAND THE
BOOKING CONDITIONS
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