Enrolment Form

3 Day Understanding Leather Course 27 – 29 June 2018

At LASRA, Dairy Farm Road, Fitzherbert Science Centre, Palmerston North, NZ

Delegates:                                                                                                                                                         

Company name:                                                                                                    

Address:                                                                                                                                                             

Post code:                                                          

Country:                                                                             

Contact person:                                                                                              

Phone number:                                                                                               

Email address:                                                                                                 

Invoice email address (if different to above):                                                                                      

Fees:                           Member $1250 (excl. GST) Non-Member $1575 (excl. GST)

Dietary Requirements:                                                                                                                                 

Email this form back to:    info@lasra.co.nz

An invoice will be issued (detailing the payment terms and options) upon receipt of completed form.

Cancellations: All cancellations must be made in writing to LASRA no later than 21 days prior to the course.  All cancellations after this date will be charged 50% of the course fee. No cancellations can be accepted within 10 days of the course and a full fee will be charged. A suitable alternative delegate can be nominated up to 2 days before the event. LASRA reserves the right to make alterations to the programme or speakers without prior notice.

I have read and agree to LASRA’s terms and conditions of booking

Name: ____________________________________         Signature   __________________