Booking form Molly Keane Writers Retreats
Name: ___________________________ Address: _________________________________________________ Phone No: _____________________ E-mail ______________________________
Payment— A Reading with Carlo Gébler €15 Payment—Workshop with Carlo Gébler €50.00
Payment—Stories in the Sand[for 3 days with Lani O' Hanlon] €200
With Writer in Residence Alison Driscoll €75
If possible it would save on administration if you can pay the full fee in advance, if for some reason you need to cancel and we have enough notice we will offer your place to another and you can attend another group or class at another time.
NB for our records please tick which workshop you are attending with the amount paid and email or post this booking form, address below, with the amount you have paid to email@example.com.
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. Email Alison below for address.
Let us know the payment method that you are using here and the amount paid ________________ Send Booking form and/or payment to Alison Driscoll email: firstname.lastname@example.org