Silk Road Academy - Booking Form

SILK ROAD ACADEMY
EXPLORING EAST & WEST: FROM A PILGRIMAGE OF POTENTIALITY TO A MOSAIC OF MAGNIFICENCE

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Welcome to Silk Road Academy
Blending the best of Western science and Oriental wisdom

PUBLIC WORKSHOP - BOOKING FORM

To register please complete the form below. Please use this form only to register to an open or 'public' workshop. The register your interest in an in-house workshop, please use the Enquiry Form.

If you prefer to do the application by hand and then send by fax or with payment by post, please download the form here.

Booking Reference ID: Please create your 8-digit booking reference consisting of your initials (first & surname - FS) and booking date (YYMMDD). Please use this reference ID when identifying your booking and payment.

BOOKING DETAILS	Mr Mrs Ms Other	INVOICE ADDRESS	(change only if different from booking details)
First Name *		If any aspect of your billing address or details are different from you regular booking address, please enter all the different details here (box on right). Not needed if no invoice required.	same as regular booking address
Surname *
Address
Town / City
County / State
Post Code / Zip
Country / Nation
Email Address *
Contact Telephone *		Do you require an invoice?	Yes No
Phone 2 (mobile)		Name of Organisation (for invoice)
Additional Delegate	confirmation will only be sent to main applicant	Name of Person 2:
Name of Person 3:		Name of Person 4:
Name of Person 5:		Name of Person 6:
Name of Person 7:		Name of Person 8:
Name of Person 9:		Name of Person 10:

* Required fields. Please make sure your email address is entered correctly, as otherwise the form will not transfer properly.

Workshop Date: Workshop Name:

Preferred Mode of Contact: Telephone Email Fax Post (Mobile Text )

How did you hear of this workshop?

Please be more specific
(e.g. name of referring person, name of newspaper, source of email etc.)

Fees:

Basic fees are £195.- per delegate per workshop.

Total Fee Calculation: Enter / amend as appropriate

Number of delegates: x £	Total Fees	£
	VAT @ 20%	£
	GRAND TOTAL	£

Payment

Once a course has been confirmed you will be sent an Invoice by email for online credit card payment, and/or sent to an Eventbrite registration / payment page or similar.

Any special comments, notes or special requirements:

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Place Booking
Please make sure your email address is entered correctly, as otherwise the form will not transfer properly.

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THANK YOU!

Workshops available for organisations in-house - to arrange see Enquiry Form. Some 'public' workshops also held West of London, England - for dates, venue and fees see Dates & Venue, to book see Booking Form.

COME AND EXPERIENCE THE FLOATING MAGIC OF REVIVED ENERGY!