Devon & Cornwall Branch Complex OCD Presented by Dr Blake Stobie 9 November 2017 Buckfast Devon – Surname First Name Title Telephone E-Mail Mailing Address Post Code Payment Membership Number (if known) Card payments Debit card - no fee Early bird for payment received by 29/09/17 Credit card - 2% £60 BABCP Member £70 Non-member processing fee Last dates for Full fee from 30/09/17 invoicing: £80 BABCP Member £90 Non-member 15/09/17 Early Bird 20/10/17 Full Fee Cheque enclosed (payable to BABCP) Debit Card Credit Card (2%fee) Payment on application only after Card Type (i.e. Visa, MasterCard) We are unable to accept American Express these dates. Name on Card Card Number Expiry Date: mm/yy / Security Code Invoice: Please complete page 4. Places are secured on payment. Invoices will not be issued unless all the required information is entered. Please state any special dietary or access requirements: Please return your registration form to: Post: BABCP Workshops Fax: 0161 705 4306 Imperial House Hornby Street E-mail: workshops@babcp.com BURY BL9 5BN INVOICES If you wish to have an invoice sent for payment of the workshop registration fee please ensure that you have completed the registration form with your contact details
Devon & Cornwall Branch Complex OCD Presented by Dr Blake Stobie 9 November 2017 – Buckfast Devon Surname First Name Title Telephone E-Mail Mailing Address Post Code Payment Card payments Debit card - no fee Credit card - 2% processing fee Last dates for invoicing: 15/09/17 Early Bird 20/10/17 Full Fee Payment on application only after these dates. Membership Number (if known) Early bird for payment received by 29/09/17 £60 BABCP Member £70 Non-member Full fee from 30/09/17 £80 BABCP Member £90 Non-member Cheque enclosed (payable to BABCP) Debit Card Credit Card (2%fee) Card Type (i.e. Visa, MasterCard) We are unable to accept American Express Name on Card Card Number Expiry Date: mm/yy / Security Code Invoice: Please complete page 4. Places are secured on payment. Invoices will not be issued unless all the required information is entered. Please state any special dietary or access requirements: Please return your registration form to: Post: BABCP Workshops Imperial House Hornby Street BURY BL9 5BN Fax: 0161 705 4306 E-mail: workshops@babcp.com INVOICES If you wish to have an invoice sent for payment of the workshop registration fee please ensure that you have completed the registration form with your contact details
DC617-Complex-OCD-reg-form.docx