Fields marked * are REQUIRED FIELDS

Please reserve a place for me on*: Deep Listening Retreat (July 20-24)

My Details:

First Name*: Last Name*:

Address*:

Town*: County*: choose... NONE Aberdeenshire Anglesey Angus Argyllshire Ayrshire Banffshire Bedfordshire Berkshire Berwickshire Brecknockshire Buckinghamshire Buteshire Caernarfonshire Caithness Cambridgeshire Cardiganshire Carmarthenshire Channel Isles Cheshire Clackmannanshire Cornwall County Antrim County Armagh County Down County Durham County Fermanagh County Londonderry County Tyrone Cumberland Denbighshire Derbyshire Devon Dorset Dumfriesshire Dunbartonshire East Lothian Essex Fife Flintshire Glamorgan Gloucestershire Hampshire Herefordshire Huntingdonshire Inverness-shire Isle of Islay Isle of Lewis Isle of Man Isle of Skye Isle of Wight Isles of Scilly Kent Kincardineshire Kinross-Shire Kirkcudbrightshire Lanarkshire Lancashire Leicestershire Lincolnshire Merioneth Middlesex Midlothian Monmouthshire Montgomeryshire Morayshire Nairnshire Norfolk Northamptonshire Northumberland Nottinghamshire Orkney Oxfordshire Peeblesshire Pembrokeshire Perthshire Radnorshire Renfrewshire Ross-shire Roxburghshire Rutland Selkirkshire Shetland Shropshire Somerset Staffordshire Stirlingshire Suffolk Surrey Sussex Sutherland Warwickshire West Lothian Westmorland Wigtownshire Wiltshire Worcestershire NOT UK Postcode*: Country:

email address*: Your preferred daytime phone number:

website: (optional)

Other stuff:

My parter is coming with me... choose... as a visitor (meals and accommodation only) as a participant I am not coming with anyone else
(NOTE: if you would like to come with your family, please contact us by phone (01822 890539) or email us to ask about availability and pricing.

I will be: resident non-resident and will be staying in Courtyard Student Accommodation not applicable

I will be coming by: Train (to Totnes) Car Air Don't know yet... Other...

Please tick the box if you require a room with disabled access (subject to availability) Yes No

My dietary requirements: I eat anything Vegetarian Vegan Gluten-free / coeliac Other If you have chosen "other", please describe your requirement:

Confirmations:

I wish to reserve a place on the Deep Listening Retreat 2009. I understand that a place will not be reserved until I have paid in full and received an email acknowledging payment and confirming the reservation.

I agree to the Terms & Conditions

I agree that my details can be held on a database for the sole purpose of organising this event.

I agree that you may keep my details and contact me in the future with items relating to Aune Head Arts only. We do not share this information with others.

or the form and start again.

NOTE: If you want to book another place, please complete payment and then fill in another form.