PEC Astronomy Enrolment Form
1. Title 2. Full Name
3. Date of Birth 4. Gender Male Female
6. Telephone Number
7. Usual Occupation
8. Amount Enclosed Payment in Full £120 £150
(please tick box) First of two instalments £60 £75
First of four instalments £30 £38
First of eight instalments £15 £19
Please include your first payment with your enrolment.
Please make cheques and postal orders payable to Planet Earth Education
11. E-mail address
Please forward Enrolment form and Remittance to :
Planet Earth Education, 45 willow Avenue, Middleton, Manchester, M24 2HE.