The PA Retreat Registration Form

Please complete the registration form below to secure your place on this unique programme.

Cost: The cost of this residential 2 day intensive programme is £1,395 + VAT, to include all
programme materials, accommodation, refreshments, meals, champagne drinks reception and networking dinner.

Name:*
Position:*
Company:*
Address*
Tel No:*
Fax No:*
Email:*
PO Number:
Please select from the dates the days you would like to attend The PA Retreat 28th & 29th July 2011
20th & 21st October 2011
15th & 16th March 2012
24th & 25th May 2012
12th & 13th July 2012
8th & 9th November 2012
I have read and accept the Terms and Conditions
Are you Human? what is 5 + 5? *