Course Enrolment Form
Unfortunately we are unable to accept payment by credit card. Please print this form and send with your cheque to the Branch Treasurer. Please read the information page for terms & conditions and other useful information.
Cheques payable to: WEA EM Birstall Branch
WEA Branch Treasurer, 35 Seagrave Road, Sileby, Leics, LE12 7TN
Please enclose a stamped addressed envelope if a receipt is required before the first meeting.
If claiming concessions, please bring evidence of status to the first class meeting.
Please enrol me/us for the following Birstall & Rothley branch WEA courses:
Course Title .................................................................................................................. Fee £............
Course Title .................................................................................................................. Fee £............
Course Title .................................................................................................................. Fee £............
Concession Code (A/B/None) ................................................................. Fee enclosed £.................
Name(s) Mr/Mrs/Miss/Ms ..................................................................................................................
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Address ................................................................................................................................................
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Postcode ................................................. Telephone ...........................................................................
Email ....................................................................................................................................................