Inservice Payment Page

Name*
First Last
Service/Organisation
Enter the email where you want the tax invoice to be sent*
Date of inservice*
Price*
Consent*
I agree to the allocated time of the inservice as outlined in the Inservice Confirmation email.
Consent*
I agree to the number of participants attending the inservice as outlined in the Inservice Confirmation email.
Consent*
I agree to pay the total costs as outlined in the Inservice Confirmation email. I agree to give five (5) days notice prior to the inservice if cancellation is required. If less than five (5) days notice is given, I agree to pay a cancellation fee of 20% of the total cost. I understand that payment is required prior to the date of the inservice workshop. If additional participants attend, above the number already paid for, I am required to provide payment for these people on the day of the workshop.
Total
$ 0.00
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Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name