Booking form

Direct Fibre Reinforced Composite Restorations
Wednesday 12th May 2010
9.00am - 1.00pm - THIS SESSION IS NOW FULL
OR 2.00pm - 6.00pm
£195 per delegate per session

(Non-refundable deposit of £100 required on booking)

To book your place simply fill out the form below and press the submit button we will then contact you to arrange payment of the non-refundable deposit.

Which session

- THIS SESSION IS NOW FULL

Surname/Family Name:
First Name:
GDC Number:
Name as you wish it to appear on name badge:
Address:
Postcode:
Your email address:
Contact phone No (no gaps):
Special Dietary Requirements:

MANDEC Course Terms and Conditions

• All deposits are non-refundable and non-transferable in all instances.

• The full balance must be paid no later than 28 days prior to the course start date. Cancellations
   made after this point will be subject to a 100% cancellation fee (ie the full price of the course).

• Applications will be accepted on a first-come, first-served basis. Places will be allocated on receipt
   of the completed registration form and payment of the deposit.

Once the booking form and deposit have been received full confirmation will be sent out.
T:0161-275-6719 or 0161-275-6645