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Please register and pay via http://83degreessouth.eventbrite.com

 

Alternatively you may print and return this registration  form below, signed, by fax to +353(0)1-686-55-59

Details of person AUTHORISED to make the booking:

CONTACT:                                                     

COMPANY:                                                    

PHONE:                                                            

        FAX:                                                                    

ADDRESS:                                                                       

                                                                                     

                                                                                     

EMAIL:                                                                              

I choose the following value proposition:

£      Economy at 299 €/day (E) for budget conscious learners that only need training and coaching, but do not need printed Courses, nor Certifications.

£      Certified at 399 €/day (C)for learners who want to get Certified, get full support in succeeding in the exams & be supplied with all course materials to get there.

£      Certified Plus at 499€/day (CP) for learners who face travel budget restrictions, we offer an all-in package that includes hotel accommodation & breakfast.

I choose the following course, course levels & dates:

                                                                                                                                                                           

I hereby register the following participants:

 

 

First Name

Last Name

E / C / CP

Day Price (ex. VAT)

Number of days

Amount

1

 

 

 

 

 

 

2

 

 

 

 

 

 

3

 

 

 

 

 

 

4

 

 

 

 

 

 

5

 

 

 

 

 

 

Total excl. VAT

 

 

 

21% VAT (see below)

 

 

 

Total incl. VAT

 

 

 

All prices are exclusive of VAT. Customers in Ireland will receive a 21% VAT payment request after registration.

Payment Details (select 1 of the following)

£      Credit Card
I hereby authorize 83 Degrees South to charge my participation fee on the following credit card:  □MasterCard                □VISA             □American Express

Card Number:                                                                                          Expiry Date:                      

Name on Card:                                                                                         Control Number:             

£      Direct Deposit: Allied Irish Bank (AIB) ° IBAN: IE59AIBK93110135597065 ° BIC: AIB KIE 2D

£      Purchase Order Available to approved customers only. P.O. number:                               


Signature Authorized Representative / Cardholder: