Training Course Booking Request

TRAINING COURSE BOOKING REQUEST

Note: Until you receive confirmation from a member of the Domestic Violence Team you DO NOT have a place on the course.
Course Title: / Tackling Domestic Violence and Abuse - The Impact on Children (Level 2)
Location:
Date:
Alternative Date:
Additional Comments:
I confirm that I have attended the Level 1 ‘Tackling Domestic Violence’ Training Course 
Applicant Details:
Name:
Job Title/ Position:
Agency:
Sector: / (e.g. Health/ Probation/ Voluntary etc)
Agency Location: / *Devon (not Plymouth/ Torbay) / Outside Devon
*delete as appropriate
Work Address:
Postcode:
Telephone Number: / Alternative Number:
E-mail Address:
Special Dietary Requirements:
Special Access Requirements:
Approver Details:
Please complete details of the person who has approved your attendance on this course.
Name:
Job Title:
Agency:
Address
(if different to above)
Postcode:
Telephone Number:
E-mail Address:
Note:
It is essential that this page is completed. Your booking form WILL NOT be processed without it.
Invoice Details:
Please complete details of where any invoice should be sent and to whom.
Name:
Address:
(if different to above)
Postcode:
If applicant is not DCC Staff please provide a purchase order number (or attach Purchase Order):
If applicant works for DCC please provide a Cost Code:
For Office Use Only
Confirmed: / Yes / No / Alternative Offered:
Comments:
Entered on System

Delegate Rate:

Level 2: Most statutory and voluntary agencies within Devon will receive this two day training at half price - i.e. £150 inclusive. The exceptions to this are:

1 Delegates who work for all statutory and voluntary agencies from Torbay, Plymouth or outside Devon, who will be charged the full cost of £300 per delegate;

2) Delegates who work in the private sector (within or outside Devon), who will be charged £300 per delegate.

3) Delegates who work for most voluntary agencies within Devon (excluding Torbay or Plymouth), who will receive the training at no charge (but only three free spaces are offered per course).

NB There is a cancellation charge of £300 if 3 weeks' notice is not provided.

If you have any queries please contact Janice Healey on the number below.

Please return completed form to:

Janice Healey

Domestic Violence Project Officer

Room G41

Chief Executive’s Directorate

County Hall

Topsham Road

EXETER

EX2 4QD

E-mail:

Telephone: 01392 382233

Fax: 01392 382286

Please note: You do not have a guaranteed place on the course until you have received confirmation from the Domestic Violence Team.

Domestic Violence/ADVA/Training/Level 2/Level 2 Booking Request Form