BOOKING FORM

ARNOLD BENNETT SOCIETY – CONFERENCE

SATURDAY 8 JUNE 2013

Full Name …………………………………………………………………………..

Address …………………………………………………………………………….

………………………………………………………………………………………….

……………………………….Post Code ………………………………………...

Tel No ………………………………………………………………………………

Email ………………………………………………………………………………..

I/We enclose my/our cheque for £…………….(£25 per person)

(Payable to Arnold Bennett Society)

I/We would like to attend the Conference Dinner at The Medical

Institute, Hartshill.  Yes/No (please delete applicable) and enclose

Cheque for £22  payable to Arnold Bennett Society.

Special Dietary requirements………………………………………………

Signature ………………………………………Date …………………………..

Advanced Booking is essential.  All bookings will be acknowledged by

Email or telephone

Please complete and return the Booking Form (and your cheque) by post to – Carol Gorton, 4 Field End Close,

Trentham. Stoke on Trent ST4 8DA

CHARITY REGISTRATION NUNBER NO 1140053