Booking Form 2012

Book your place online NOW for Summer School 2012

Personal Details
	Title *
	Forename(s) *
	Surname *
	Date of Birth *
	Applications cannot be accepted from students who will be under 18 or over 80 on the first day of the School.

	Address 1 *
	Address 2
	Town/City *
	County *
	Postcode *
	Country *
	Telephone Number *
	Mobile Telephone Number
	Email Address *
Emergency Contact Details
	Name *
	Relationship *
	Telephone Number *
Course Selection - whilst every effort will be made to book you on your first choice this may not always be possible.
	Please select the course you would like to attend as your first choice. *
	Would you like to select a second choice in case your first choice is over subscribed?
	Optionally select additional Short Course that you wish to attend.
	Please select your voice range (if applicable).
?	Please provide details of previous experience, relevant to your course choice, and what you want to achieve from the course. *
	Have you attended Summer School before? *
	Do you wish to be identified as a First Timer?
	Please provide details - year and course.
Accommodation - please note all residential accommodation en-suite for one person.
	Please indicate whether you are an early bird or a night owl. *
Free T-Shirt
	If you book before the 29th February 2012 you will be entitled to receive a free limited edition T-shirt. Please indicate your size small, medium, large, X large, XX large

Other Details
	NODA Membership *

	Please provide the society name.
	Which NODA region do you belong to? *
?	Please let us know if you have any medical training. *
	Please specify.
	Please provide details of any dietary requirements. If none please state. *
	Please provide details of any other requirements. If none please state. *
	How did you find out about Summer School 2012. Please select all that are applicable.	NODA WebsiteNODA Theatre BusinessNODA Regional Magazine NODA E-mail NewsletterRegional Rep/CouncillorSociety Previous StudentFacebook Other
Fees
	Please select your fees based on your course and residential status. Please note that to complete your booking a £100 non refundable deposit (£50 per course for Short Courses) will need to be paid via debit/credit card over the phone by calling NODA headquarters with your card details. (A 5% charge is payable for credit card payments.) If you are applying for a bursary and your application is unsuccessful and you subsequently decide not to attend Summer School then your deposit will be refunded. *

?	How would you like to pay the balance of your fees. *
?	Have you applied for a NODA bursary? *
Terms & Conditions
	I hereby declare that I have read, understood and will abide by the terms and conditions, as set out here, for Summer School 2012. Particular attention is drawn to the cancellation policy and all students are strongly advised to arrange their own personal accident and cancellation insurance. *