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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