Booking form Molly Keane Writers Retreats
Name: ___________________________ Address: _________________________________________________ Phone No: _____________________ E-mail ______________________________
Payment 10 Lyrics€286 - deposit 100 Please pay deposit and/or full fee by 30th of March 2019
Payment -Time to Write [for 3 days] €250 - deposit €100, full payment by the 30th of May 2019
If possible it would save on administration if you can pay the full fee in advance.
NB for our records please email or post this booking form email@example.com and pay deposit and/or full fee by:
1. Bank transfer – or lodgement with your name and workshop written clearly - Name of bank: AIB Branch: Youghal, Co Cork Name of account: Molly Keane Writers Retreats Bank account number: 08918098 Sort Code: 934305 BIC: AIBKIE2D IBAN: IE18AIBK93430508918098
if this is not possible then by post - cheques or postal orders. Please make cheques out to Molly Keane Writers Retreats.
Let us know the payment method that you are using here ________________ Send application forms and/or payment to Lani O' Hanlon, Crobally, Sean Phobal, Co. Waterford. email: firstname.lastname@example.org