DHARMAMIND
BOOKING FORM
COTSWOLD
4 DAY NEW YEAR RETREAT
£192(SS) £208
DEC.27th
/ 31st 2011
Name:..................................................................................................................................................................................................................................................................................
Address:.............................................................................................................................................................................................................................................................................
............................................................................................................................................................................................................................................................................................
E-mail:
(please PRINT clearly)..........................................................................................................................................................................................................................................
Contact
phone no:................................................................................................................................................................................
Do you contribute to SANGHA SUPPORT? ..........................YES / NO
Do
you have any special dietary needs?
BANK TRANSFER
Non-returnable / non-transferable £50 deposit through a bank transaction:
DharmaMind Buddhist Group
Sort: 30-90-62
Acc. No: 0816568
Please notify Matthew to confirm transfer when emailing this Booking Form.
CHEQUE
Please enclose a non-returnable / non-transferable £50 cheque made payable to ‘DharmaMind Buddhist Group’, and post along with this Booking Form to:-
Shropshire Autumn Retreat 2011
DharmaMind Buddhist Group
107 Parkland Drive
Leeds
West Yorks
LS6 4PT
Contact Matthew: 0113 2662678 e-mail: team@dharmamind.net
Payment by PayPal can be arranged on request.
Signed
..Date
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