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Course Booking Form

Please complete this form as fully as you are able, the information you provide will enable us to give you the best possible learning experience

If returning this form by post please send to:
DrugTrain Booking Service, 120 Pontefract Road, Hoyle Mill, Barnsley, S71 1JA

PDF Version PDF version, this will open in Adobe Reader.

Word Version Word version, this will open in Microsoft Word.

If you would like this document in another format or you are having problems
completing it, please call us on 01226 738 321

The Course

About You

As you would like it to appear on your certificate

Please ensure this is spelled correctly

How would you like us to contact you? (please ensure your chosen method is completed correctly above)

Post Email Phone SMS Text

Anything else you want us to know? (learning needs, access issues, dietary requirements etc.)


How would you like to pay?


If you are paying by cheque, please make it payable to DrugTrain and it must be received at least 2 weeks before the start of the course


If you would like us to invoice your organisation, please state:

Before submitting this booking form please read the Terms and Conditions which can be found at www.drugtrain.org.uk/t&c.html