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 Mosaic Course Booking Form

Please fill in this form and use your browser's print command (normally in the File menu) to print it, then sign it and post it along with a cheque for your deposit to the address at the bottom of the page. If you encounter any problems please contact us via the Contact page.

First name:

Last name:

Address 1:

Address 2:

Town/City:

County/State:

Post Code/Zip:

Country:

Email:

Telephone:

Please write date required:

.........................................................

I enclose a deposit of £50.00 per participant (non refundable) made payable to Martin Cheek for this booking. I understand that the balance of the course fee must be paid on the first day of the course.

Signed:

Todays Date:

Please send the completed form and cheque to:

Flint House Art
Flint House
21 Harbour Street
Broadstairs
Kent
CT10 1ET
United Kingdom

If you encounter any problems please contact us via the Contact page.