Training - Booking form

As from 1 April 2009 all Health Promotion Agency responsibilities have been transferred to the Public Health Agency.

Booking form

Training event details

Training event title

Training event dates (see here for details)

Your details

Title:
First Name:
Surname:
Job Title:
Organisation:
Type of organisation:
Work Address:
Postcode:
Work Tel:
Work Fax:
Email:

Please specify any special dietary or access requirements

Payment details (if applicable)

Please mark the appropriate box.

I am forwarding a cheque for the course fee
(Cheques should be made payable to: Health Promotion Agency for Northern Ireland)

I wish to be invoiced
Purchase order number required:
Invoices should be settled within 30 days.
(Please indicate who should receive invoice)

Terms and Conditions

Confirmation and further information will be sent to you prior to the event.
All cancellations must be made in writing and sent to the HPA by email info@hpani.org.uk or fax on 028 9031 1711 (or 0044 28 9031 1711 from outside the UK).
For events where a fee is being charged, cancellations received up to 14 days prior to the event will be subject to a 50% cancellation fee. Cancellations received with less than 14 days notice will be subject to a 100% cancellation fee.
You may nominate another person in lieu of cancellation. Any proposed change must be notified to the HPA in writing giving the name, job title, address and phone number of your replacement.

I accept the terms and conditions above.

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