Training Booking FormTraining Booking Form Your / Company Details Your Name * Company Name CITB Levy Reg. Number Single Line Text Email * Phone Number * Address (For certificate) * Address Line 2 City * Post Code Is the invoice address different? No Yes Discount Code Invoice Address line 1 Invoice Address line 2 Invoice Address City Invoice Address Post Code Course Details Training Course / Service Title Date(s) Start Time Qty / Candidates Total Cost (plus VAT) Candidates Names(s) / Notes Payment Method Select one payment method below NOTE: If accepting a discount you must provide card details to make payment immediately. * Electronic bank transfer CardPlease make your company name as the reference and make payment to: Courtley Account Number: 10111530 Sort code: 16-24-06 Payment Ref (use company name) Date of payment Card number Expiry Date CVS Postcode Name on Card By ticking this box, you are agreeing to us adding you to our mailing list to keep you informed of helpful and interesting health, safety & training updates. Yes please Please leave this blank Send Form If you are human, leave this field blank.