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					ILM Booking Form
                                                                                                              *optional fields
 Your Name:

 Current Job role \ title: (or most recent job title if      Managerial experience*: (e.g. aspiring first line
 not currently working).                                     manager / practising first line manager).




 Qualifications*: (any Business courses completed \          Reason for interest*: (please briefly state what you
 passed)                                                     hope to gain from this course).




 ILM Qualification you would like to study:
      L2 Award Effective Team Member
      L2 Cert Effective Team Member
      L2 Award Team Leader
      L2 Cert Team Leader
      L3 Award Effective Management
      L3 Cert Effective Management
      L5 Award Leadership & Management Skills
      L5 Cert Leadership & Management Skills
      L5 Diploma Leadership & Management Skills

 Home Address:                                               Work Address:




 Telephone:                                                  Telephone:

 Email:                                                      Email:

Payment Details:
     I am paying for the course myself
     My employer is sponsoring this course

I would like to pay by:
       Credit or debit card
       Invoice to my home address
       Invoice to my company address
       Cheque

Please debit my Visa/Mastercard/Switch/Connect/Solo. Please note we do not accept Diners club or American Express

Card Number:



Signature:                                         Expiry Date:
Name on Card:                          Switch Issue No/Start Date:




Please make cheques payable to ‘London Metropolitan University’

If you wish your company to be invoiced by us, please provide a purchase order number and a contact name:




Terms & Conditions

   To undertake this course you must pay a separate registration fee to the Institute of Leadership &
    Management. The ILM reserves the right to refuse applications.

   In order to assist the invoicing process, please ensure that Purchase Orders are sent to Kathryn
    Georghiou, London Metropolitan University, Stapleton House, 277-281 Holloway Road, London N7 8HN

   There will be a cancellation fee of 25% should you cancel 14 days prior to the start of the course.
    Cancellation and non-attendance once the course has commenced will incur the full fee

   The MDU reserves the right to change the details of this programme without prior notice


Please return this signed form by email, post or fax to:

k.georghiou@londonmet.ac.uk

Kathryn Georghiou,
London Metropolitan University,
Stapleton House,
277-281 Holloway Road,
London N7 8HN

Tel: 020 7133 3993
Fax: 0207 133 3806




I confirm that I have read and understood the terms and conditions.



Signature of delegate: ….…………………………………………………………..

Authorised signature (if Company is paying): …………………………………….

Date: …………………………………………………………………………………...

				
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posted:5/27/2013
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