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Please complete the form below to book a place on one of the courses.
The dates available are:

Crewe Community Safety Centre, Crewe

Thursday 22nd January 2009  1pm 'til 3pm
Thursday 22nd January 2009  7pm 'til 9pm
Saturday 24th January 2009  10am 'til 12pm

Ness Gardens, Ness, South Wirral

Wednesday 28th January 2009  2pm 'til 4pm
Wednesday 28th January 2009  7pm 'til 9pm
Saturday 31st January 2009  10am 'til 12pm

Questions marked with an asterisk (*) are required fields to be completed.

1. Name: *

2. Address: *

3. Postcode:

4. Tel No (Daytime):

5. Tel No (Evening):

6. Email address:

7. Where did you hear about this course? Local Paper Leaflet through door Website Your Cheshire Friend 'The Gentian' (Friends of Ness Newsletter) Other

8. If you answered 'Other' to question 7, please specify:

9. Would you like any further information?

10. Dates: Please Choose... Crewe - Thursday 22 January 2009 1pm til 3pm Crewe - Thursday 22 January 2009 7pm til 9pm Crewe - Saturday 24 January 2009 10am til 12pm Ness Gardens - Wednesday 28 January 2009 2pm til 4pm Ness Gardens - Wednesday 28 January 2009 7pm til 9pm Ness Gardens - Saturday 31 January 2009 10am til 12pm

11. Are you a 'Friend of Ness Gardens' Yes