APPLICATION FOR STEAM DRIVING COURSE
Name:.............................................................................................
Address: ..........................................................................................
.......................................................................................................
Post
Code: .................................
Daytime Telephone Number: .......................................................
Evening Telephone Number: .......................................................
Driver's
Name: ..........................................................................
Driver's Telephone
Number: ......................................................
Driver's Address:
......................................................................
.................................................................................................
Date
of course 1st
Choice: ............................ Time: ..................
Date of
course 2nd
Choice:............................. Time: ..................
Gift Voucher
Required
(Yes/No)....................
Course FEES UNTIL 29TH FEBRUARY 2009 £80.00 for 1 hour and £150.00 for 2
hours.
Course FEES FROM 1ST MARCH 2009 £85.00 for 1 hour and £160.00 for 2
hours.
I enclose a cheque/postal order for :-................made payable to
Peak Rail plc.
OR Please debit my Visa/Mastercard/Switch
No........../........../........../..........
Start Date
................
Expiry Date ................
Issue Number
................
Security Number .......................... (The last 3 numbers
on the back of the
card)
Signed.................................Date....................
Please
send this form to :-
Peak Rail plc
Matlock Station
Matlock
Derbyshire
DE4
3NA
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