Course Application Form - Mr Soot Chimney Sweep

Please be aware if that, if any information is insufficient and not received within 7 days of the course start date, we reserve the right to issue a refund to any payment you may have made, minus an administration fee of £120 plus VAT.

Name *

First

Last

Company Name (if applicable)

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

Email *

Course Applied For *

Course Start Date *

Emergency Contact Name *

Relation To Emergency Contact (E.g - Parent/Partner/Friend/Colleague) *

Emergency Contact Telephone Number *

PLEASE ADVISE MR SOOT TRAINING CENTRE SEPARATELY OF ANY DIETARY NEEDS, ALLERGIES, MEDICAL CONDITIONS OR DISABILITIES RELEVANT TO YOUR ATTENDANCE AT THE FACILITY FOR THIS COURSE IN THE BOX BELOW. IF YOU HAVE NONE, PLEASE WRITE ‘NONE’. *

I want to receive additional information from the Training Centre about other courses and/or industry events at the contact details above. I can unsubscribe from marketing communications at any time *

Confirmation *

I confirm all the information provided is correct and accurate. I give consent for the information to be used and shared with authorities in relation to matters such as course requirements, health and safety, welfare, public protection and any other scenario deemed necessary by the Training Centre.

Today’s Date *

Liverpool

Stockport

Manchester

Wigan

Preston

Training Centre