CHARNEY MANOR

GUIDED RETREATS BOOKING FORM

(Bookings are not firm until a booking form and deposit have been received.)

Event (title)
 
Date
 

 

Name
 
Address
 
 
 
 Post Code
 
Telephone (day)
 
(evening)
 
e-mail
 

I enclose a non-returnable deposit of £65 payable to Charney Manor. (Please enclose a SAE if a receipt or confirmation is required). The balance of £100 is due three weeks before the event, when a reminder will be sent. Bursaries of up to 50% of the cost are available if requested when booking (one per person per year).

I require a bursary (please tick box) c

Dietary requirements  Vegetarian / Vegan / Other special needs (Please specify)
 
I am willing to share a room Yes/No
Please give details of any other special needs (e.g. ensuite ground-floor rooms suitable for disabled users are available)
 
I would like transport from Didcot Parkway BR   c Southmoor bus stop   c
 
How did you hear about this event?
 

Please return to: Sheila Terry
Charney Manor, Charney Bassett, Wantage. Oxon OX12 0EJ

01635 868206
e-mail: charneymanor@quaker.org.uk