Registration Form 2009 UK

Registration Form

2009

This needs to be adjusted, please do not register yet

- please select the button of your choice -

The undersigned :	Ms. Mrs. Mr. required
Last Name :	required
Initials :	required
First Name :	required
Address :	required
Zipcode :	required
City :	required
State :	required
Country :	required
Date of birth (dd-mm-yyyy) :	required
Occupation :
Telephone number :	required
Fax number :
E-mail address :	required
How did you find us? :	required
	Fill in the below,when this is the invoice address:
Company name :
Invoice address : (if not the same as above)
Zipcode :
City :
State :
Country :

...hereby registers for the following Course:

IMPORTANT

With this form you can only register for one course at a time.

If you would like to register for more than one course:

After sending this form, you can use the back space button.

Then you just select the course button again.

- Select the Course button of your choice -

Hand Tied Bouquet Course (English & Dutch spoken)

	Course code	Starting Date	Ending Date	Price
	HBI1D-2009	Thursday 26 February	Thursday 27 February	� 197,50
	HBN1D-2009	Friday 17 April	Friday 24 April	� 197,50
	HBI2D-2009	Thursday 28 May	Friday 29 May	� 197,50
	HBI3D-2009	Wednesday 29 August	Thursday 20 August	� 197,50
	HBN2D-2009	Friday 9 October	Friday 16 October	� 197,50
	HBN3D-2009	Friday 13 November	Friday 20 November	� 197,50

1-week Bridal Floral-Work Course (English & Dutch spoken)

	Course code	Starting Date	Ending Date	Price
	BWI1D-2009	Monday 20 April	Friday 24 April	� 1.000,-
	BWI2D-2009	Monday 16 November	Friday 20 November	� 1.000,-

Table Arrangement Course, 3 afternoons (English & Dutch spoken)

	Course code	Starting Date	Ending Date	Price
	TAI1M-2009	Friday 5 June	Friday 19 June	� 142,50
	TAN2M-2009	Friday 27 November	Friday 11 November	� 142,50

Christmas Course (day, afternoon, evening) Englisch & Dutch spoken

	Course code	Starting Date	Day time	Price
	KTN1A-2009	9 December	evening	� 47,50
	KTN2A-2009	10 December	evening	� 47,50
	KTN3A-2009	11 December	evening	� 47,50
	KTN1D-2009	12 December	day	� 97,50
	KTN1M-2009	13 December	afternoon	� 47,50
	KTN2D-2009	16 December	day	� 97,50
	KTN4A-2009	16 December	avond	� 47,50
	KTN5A-2009	17 December	avond	� 47,50
	KTN3D-2009	18 December	day	� 97,50
	KTN2M-2009	19 December	afternoon	� 47,50

Professional Dutch Floral Design Certificate Courses

In total 6 Modules of 5 days each (English spoken)

	Course code	Starting Date	Ending Date	Description	Price
	VO111-2009	2 March	6 March	Module 1	� 1.000,-
	VO112-2009	24 August	28 August	Module 1	� 1.000,-
	Course code	Starting Date	Ending Date	Description	Price
	VO221-2009	9 March	13 March	Module 2	� 1.000,-
	VO222-2009	31 August	4 September	Module 2	� 1.000,-
	Course code	Starting Date	Ending Date	Description	Price
	VO121-2009	2 March	13 March	Module 1 to 2	� 1.900,-
	VO122-2009	24 August	4 September	Module 1 to 2	� 1.900,-
	Course code	Starting Date	Ending Date	Description	Price
	VO341-2009	16 March	27 March	Module 3 to 4	� 1.900,-
	VO342-2009	7 September	18 September	Module 3 to 4	� 1.900,-
	Course code	Starting Date	Ending Date	Description	Price
	VO561-2009	30 March	10 April	Module 5 to 6	� 1.900,-
	VO562-2009	21 September	2 October	Module 5 to 6	� 1.900,-
	Course code	Starting Date	Ending Date	Description	Price
	VO141-2009	2 March	27 March	Module 1 to 4	� 3.750,-
	VO142-2009	24 August	18 September	Module 1 to 4	� 3.750,-
	Course code	Starting Date	Ending Date	Description	Price
	VO361-2009	16 March	10 april	Module 3 to 6	� 3.750,-
	VO362-2009	7 September	2 October	Module 3 to 6	� 3.750,-

6-weeks Professional Dutch Floral Design Diploma Course (English spoken)

	Course code	Starting Date	Ending Date	Description	Price
	VO161-2009	2 March	10 April	Module 1 to 6	� 5.600,-
	VO162-2009	24 August	2 October	Module 1 to 6	� 5.600,-

3-weeks Advanced Dutch Floral Design Diploma Course (English spoken)

	Course code	Starting Date	Ending Date	Price
	VVI1D-2009	13 May	5 June	� 3.300,-

3-weeks Master Course in Dutch Floral Design (English spoken)

	Course code	Starting Date	Ending Date	Price
	VMI1D-2009	9 June	27 June	� 3.800,-

Private Lessons in Dutch Floral Design (English or Dutch)

	Course code	Number			Date		Date
	PRIVATE-2009				dd-mm-yyyy		dd-mm-yyyy
		Number of days:		from:		to:
		Number of persons (max. 4):

Lessons for Organised Groups (English or Dutch)

	Course code	Number			Date		Date
	GROUPS-2009				dd-mm-yyyy		dd-mm-yyyy
		Number of days:		from:		to:
		Number of persons (min. 10):

Do you wish to make reservations for a Boarding House?

					Date		Date
	reguired				dd-mm-yyyy		dd-mm-yyyy
	Yes	Number of nights:		from:		to:
	No
	Flight schedule	Arrival date:				Departure date:
How did you find us?

Do you prefer smoking or non-smoking in the Boarding house?

	I prefer smoking.
	I prefer non-smoking.
	I do not mind if there are smokers in the house.

Are you a Vegetarian?

	Yes, I am a Vegetarian.
	No, I am NOT a Vegetarian.

Please check if the choices you made are correct before you register definitely.

By clicking on the REGISTER button below you agree with the terms and conditions of

Boerma Instituut.