The PA Retreat Registration Form

Please complete the registration form below to secure your place on this unique programme.

Cost: The cost of this residential 2 day intensive programme is £1,250 + VAT, to include all
programme materials, accommodation, meals and automatic membership to The 100 Network.

Name:*
Position:*
Company:*
Address*
Tel No:*
Fax No:*
Email:*
PO Number:
Please select from the dates the days you would like to attend The PA Retreat 9th & 10th September 2010
11th & 12th November 2010
I have read and accept the Terms and Conditions