Application Form

 
Brighton Therapy Group (print this page) 




 



To reserve a place on the therapy group, please state the date you would like to join.


Please enclose a non-refundable deposit of £60. The fee for remaining days will be due in advance of each meeting.


Cheques should be made payable to Sue Chamberlayne and sent to 76 Ditchling Road, Brighton, BN1 4SG. 



        Therapy Group Brighton               State date you wish to join  .............................

      2 days, Fri/Sat, quarterly


      


        Name: .....................................................................................................


        Address: ..................................................................................................


        ................................................................................................................


        Tel: .........................................................................................................


        E.mail: .....................................................................................................