Enrolment Form
Please return to:
Higham Hall, Bassenthwaite Lake, Cockermouth, Cumbria CA13 9SH

I wish to attend the following Course as: Resident Non-resident
Course:
Course Ref:
Dates:
Full Fee or Deposit:
TOTAL AMOUNT ENCLOSED:
Title:
First Name:
Surname:
Address:
Postcode:
Tel. No. (Day):
E-mail
Special diet or vegeterian
Bedroom requirements:	single double twin-bedded en-suite (if available) if there is no accommodation available, I would like to know about local bed & breakfast accommodation YES/NO

I wish to pay by:     Cash     Cheque

Cheques payable to HIGHAM HALL COLLEGE

To MASTERCARD/VISA/MAESTRO I authorise you to debit my account with the amount of : £

Card number

Expiry date:

Issue No. (Maestro) or Start Date:

Security No. (last 3 digits on the back of card)