Archie Therapy Booking Form Introducing A School Dog CPD Booking Form Question Title * 1. Contact Name OK Question Title * 2. Which Course are you booking? Oct/NOV 2019 - Finished March 2020 - Finished June/July 2020 - Finished Friday 6th March Keighley - Finished Blackpool Nov 17th & Dec 1st 2020 4:45 - 8pm OK Question Title * 3. Your info School/Company School/company address School/company postcode Job title Email address (you would like to be contacted at) Invoice Email Address Your Phone contact no OK Question Title * 4. How many staff will be attending? One Two Three Four OK Question Title * 5. Staff names and job positions (If known) OK Question Title * 6. How would you like to pay Cash Cheque Bank Transfer Via Invoice Other (please specify) OK Question Title * 7. Will you be bringing dog on course? Yes No OK Question Title * 8. Dog Info (if applicable) Name Breed Age Gender How long owned dog Where did you get dog from Brief background of training Aware of your responsibilities to ensure vancines, worming & flea treatments and insurance are up to date OK Question Title * 9. What would you like to gain by attending this course? OK Question Title * 10. Are you aware of terms and conditions of booking on this course? Yes No OK DONE