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APPLICATION FORM You can print this out, fill it in and mail it to: Jim Wingate Ty Gwyn, Ystumtuen, ABERYSTWYTH, Ceredigion SY23 3AF, Wales U.K.
Please enclose a cheque for £150 or €230 or US$230 | made payable to "Jim Wingate" Sorry, credit cards and Eurocheques cannot be accepted.
Your name
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Your Address
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Country
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Date of birth
day/month/year
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Telephone
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Fax
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e-mail
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About yourself e.g. how you want to use the course,
where you want to teach,
what ages and levels you want to teach,
what experience you have (if any).
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Signature
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