GUIDED BY ANGELS COURSE ENROLMENT FORM

Please print and complete this from and post to the address listed at the bottom.

Name:___________________________________________________________________

Address 1:________________________________________________________________

Address 2:________________________________________________________________

Address 3:________________________________________________________________

Town / City:_______________________________________________________________

County / State / Region:______________________________________________________

Country:__________________________________________________________________

Postcode / Zip Code:________________________________________________________

Telephone:________________________________________________________________

Email Address:_____________________________________________________________

____ (tick here if you would like to be added to our AngelSpeak newsletter)

Optional information:

Where did you first hear about Guided By Angels?__________________________________

Are you a complimentary health therapist? (circle as appropriate):

Yes - Full Time___ Yes - Part Time____ No____

How long have you been interested in angels?______________________________________

PAYMENT OPTIONS
You can pay for the course either in full (and get a discount), or by interest free monthly payments.

OPTION ONE - FULL PAYMENT - we offer a 15% discount for payment in full.
I wish to pay for the course IN FULL by credit card or cheque and get a discount.
I enclose a cheque / card payment for £85. Please make cheques payable to Lifeworks.

Credit/Debit Card Details (Visa, Mastercard, Switch, Electron or Solo):

NAME ON CARD:________________________________________________________

CARD NUMBER :_________________________________________________________

EXPIRY DATE : ____________________ SECURITY NUMBER (Last 3 digits): _______

ISSUE NUMBER (SWITCH ONLY) :____________________________

Signed ______________________________________ Date ____________________

OPTION TWO - MONTHLY PAYMENTS (available by Standing Order only)
I wish to pay for the course in 10 installments of £9.99 per month, by standing order.

OPTION THREE - UK CUSTOMERS ONLY (available by Standing Order only)
If you would prefer us to send you printed course notes each month, rather than send them by email,
you may use this option. Regretfully we can only offer this to our UK customers.
I wish to pay for the course in 10 installments of £18.50 per month, by standing order.

Standing Order to pay Lifeworks

NAME OF YOUR BANK _____________________________________________

SORT CODE: _____ ______ _____

ACCOUNT NUMBER:________________________________________________

NAME OF ACCOUNT ________________________________________________

Address of your bank __________________________________________________

___________________________________________________________________

___________________________________________________________________

To the Bank Manager - Please pay the amounts shown below on the dates shown.

PAY THE AMOUNT OF ____________________________ PER MONTH

NAME OF BANK: Bank of Scotland

ON THE (DATE): 20TH OF EACH MONTH

NAME OF ACCOUNT: LIFEWORKS

SORT CODE: 12-24-81

ACCOUNT NUMBER: 06341829

FOR (NUMBER OF MONTHS): 10 months

Signed ______________________________________ Date ____________________

Please send the forms to:


LifeWorks.
13 Bluebell Green, Chelmsford, Essex, CM1 6XF, United Kingdom
Telephone: +44 (0) 1245 460057

THANK YOU.