Event Booking Form | Counselling Matters

Name*

First NameLast Name

Organisation Name

If required

Email Address*

example@example.com

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityCounty

Postode

What do you want to book for?*

EFT Level 1 only (£145)EFT Level 2 only (£290)EFT Levels 1 and 2 (£435)

Please note that EFT Level-1 is an essential prerequisite for participation in Level 2. If you are looking for Level-2 only, the trainer will need to see your certificate of completion of an approved EFTi Level-1 course before the course starts. If you have any questions regarding this, please email laura@counselling-matters.org.uk.

For how many people?*

Total Due (£)*

Please enter the names and email addresses of the other people attending (one per line) in the format Full Name, Email address. E.g. John Smith, johnsmith@gmail.com*

These will be only used to produce attendance certificates and send out course materials etc.

Do you have any special requirements?

Lunch will be offered each day. Please indicate any allergies or other dietary requirements.

How do you want to pay?*

Full payment by credit/debit cardFull payment by bank transferPayment by instalments (⅓ deposit payable now)Payment on invoice (established organisations only)

Due Now

Payment Details*

GBPEvent Booking

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please note that charges will show on your statement as c-m.click

Please make a payment of £{totalDue} by bank transfer to Starling Bank using the following details:

Account Name: Counselling Connections Limited
Account Number: 28272401
Sort Code:60-83-71

International payments might need our IBAN Number: GB60SRLG60837128272401

Please quote your name as a payment reference. Bookings are not confirmed until payment is received.

As you have requested to pay in instalments we will contact you to finalise the payment details. We can split the balance over several payments but payment must be completed before the course starts.

As you have asked to pay on invoice, we will raise this in the next few days. Our invoice terms are 14 days. Your booking is not confirmed until payment is received.

Can we inform you about future events?*

YesNo

I acknowledge that this is a firm booking and full payment will be required. Bookings are transferable.*

This is a firm booking and I will make full payment as agreed.