Title: / First name: / Surname:
Address:
Postcode:
Tel.
Email:
Delegate 2
Title: / First name: / Surname:
Address:
Postcode:
Tel.
Email:
Delegate 3
Title: / First name: / Surname:
Address:
Postcode:
Tel.
Email:
Delegate’s Company / Church / School Details
Invoice Contact (if applicable)
Address:
Postcode:
Tel.
Email:
Location: The Godly Play Room, St Mary’s Church, Putney High Street, London, SW15 1SZ
3 Saturdays: 7th21stOctober, 4th November
Led by:Sue North-Coombes and Stuart Lee
Godly Play Three Day Courses begin at 9.30a.m. each day and finish at 6.30 p.m. for evenings 12.
On the last day the course ends @ 5.30pm
FEES £295.00
The course fee includes training fee, handouts, and morning/afternoon refreshments for each delegate.
Precise details about the course/ venue/ timings etc. will be sent out a few weeks before the course.
SECTION 2: DIETARY / OTHER REQUIREMENTS
Please detail below any delegates who have special dietary requirements.
(Specify who if multiple application)
......
......
Are there any additional needs that you have that we can help you with?
......
......
SECTION 3: METHODS OF PAYMENT
Cheque
Please make cheques payable to Godly Play UK
PLEASE SEND FULL FEES WITH YOUR BOOKING FORM TO:-
Sheila Rogers (GP Admin.)
18 Waring Way
Dunchurch
Rugby
Warwickshire
CV22 6PH
Invoice
Invoice Ref/Purchase Order No: ......
Date: ......
BACS
Bank name: CAF Bank (Charities Aid Foundation)
Sort code:40-52-40
Account no:00024691
Account name: Godly Play UK
SECTION 4: TERMS AND CONDITIONS
Fees
Invoices issued must be paid within 30 days of the invoice date.
Cancellations
A £25 administration fee will be charged for cancellations made up to ten weeks prior to the start of the course. Cancellations thereafter will be liable to the loss of the full fee. Substitutions may be made at any time prior to the start of the course.
Please note that on rare occasions, due to low numbers, courses are cancelled at late notice. Godly Play UK cannot be held responsible for any loss incurred by individuals as a result of us having to cancel an event although the full course fee will be returned.
SECTION 5: HOW DID YOU FIND OUT ABOUT THIS COURSE?
Godly Play website / Other website (please specify)......
Email Publication (please specify) ......
Recommendation ......
Other (please specify) ......
SECTION 6: SIGNATURE
I wish to book the delegate(s) on the course(s) detailed above. I have read and accept the booking terms and conditions in Section 4.
Print Name: ......
Signature: ...... Date: ......
SECTION 7: Data Protection
By signing this part of the form you agree to your details being held on the Godly Play databaseto inform and update you on events that might be of interest to you. We will not disclose this information to any third parties.
□Please tick box if you do not wish your details to be held
Gift Aid declaration – Godly Play UK*
Please treat
□The enclosed gift of £ ------as a Gift Aid donation;
OR
□All gifts of money that I make today and in the future as Gift Aid donations; OR
□All future gifts of money that I make from the date of this declaration as Gift Aid donations.
Please tick the appropriate box
I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for the current tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities and Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for the current tax year.
I understand that other taxes such as VAT and Council Tax do not qualify.
I understand the charity will reclaim 25p of tax on every £1 that I have given.
Donor’s details (If different from those given on page 1)
Title ------Initial(s) ------Surname ------
Home address ------
------
Postcode ------Date ------
Signature ------
Please notify Godly Play if you:
- Want to cancel this declaration
- Change your name or home address
- No longer pay sufficient tax on your income and/or capital gains.
Tax claimed by Godly Play
• Godly Play will reclaim 25p of tax on every £1 you give on or after 6 April 2011.
If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self Assessment tax return or ask HM Revenue and Customs to adjust your tax code.
* Godly Play UK is a registered charity (no.1116846). Your donation will assist with bursaries for those in financial need and contribute to the development of Godly Play throughout the UK.