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PLEASE PRINT OUT AND MAIL
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KONJAKU SHIN NATIONAL SCHOOL OF KARATE SATURDAY 17th and SUNDAY 18th MAY 2008 |
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Note: Places Must Be Booked in
Advance. No Applications On The Day. |
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Name ............................................................................................................................................................................... Address .......................................................................................................................................................................... ........................................................................ Post code ............................................................................................... Grade ............................... Dojo ............................................ Association .................................................................. Please tick: 1 session 2 sessions 3 sessions full course Grading Grade Attempting ..................
kyu
Total fee enclosed: £ ...................... |
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PAYMENT METHOD Card Type (eg: Visa/Mastercard) ............................................. Card Number ...../...../...../...../...../...../...../...../...../...../...../...../...../...../...../...../ Valid from .... /.... /.... /.... / Expiry Date ..... /.... /.... / .... / Security Number .... /.... /.... /..../ Switch Issue Number .... /.... / Mail to: |
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