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Training by Schneider Electric - WF Senate

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<strong>Schneider</strong> <strong>Electric</strong> <strong>Training</strong><br />

Booking form, + credit card booking via fax<br />

This form is for fax bookings and ALL credit card payments<br />

Please photocopy this form, complete all information and fax to 024 7684 7545 for processing along with a<br />

company letterhead or purchase order<br />

Tel: 024 7684 7564<br />

Email: angela.pryor@gb.schneider-electric.com<br />

Course details<br />

Course Code<br />

Course Title<br />

Course Date<br />

Contact details<br />

Name<br />

Position in Company<br />

Company<br />

Contact Name<br />

Address<br />

Town County Post Code<br />

Email<br />

Telephone<br />

Fax<br />

Payment<br />

Course cost £<br />

Payment/Credit Card Type Purchase order Cheque Master Card VISA Diners AMEX<br />

PO Number or cheque number or<br />

Credit card number<br />

Name on credit card Credit Card Expiry (MM/YYYY)<br />

Comments<br />

50

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