Name Address and Phone No.

I will be coming to the AGM / I would like to come finances permitting / I cannot attend.
I will be arriving at Time:   At   by Car / Train / Bus
NUMBER IN PARTY
ACCOMMODATION WANTED Please circle - FRIDAY 3rd / SATURDAY 4th / SUNDAY 5th
Please state how many. Room for 1   Twin for 2   Double for 2   Room for 3  
Wheelchair accessable room? YES / NO
Any Special Facilities required?
Please state if special diet.
Deposit of £25 per person enclosed YES/NO Full Payment t.b.a. by the 4th August 1999.
PLEASE DO NOT HESITATE TO RING TO DISCUSS THIS - we will do all we can to help.

© Copyright The Lincolnshire Post-Polio Network 1999.
Document preparation: Chris Salter, Original Think-tank, Cornwall, United Kingdom.
Document Reference: <URL:http://www.zynet.co.uk/ott/polio/lincolnshire/linkpin/forms/form5.html>
Created: 21st August 1999. Last modification: 21st August 1999