Request a Booking

Course Details

Course Name:

*

Start Date:

*

Location:

*

Personal Details

Contact Name:

*

Key Stage Level (enter current level you are teaching):

KS1
KS4
NQT
Other
Not applicable

*

Job Title:

*

School/Organisation Name:

*

School/Organisation Address:

Main Contact Number:

*

Mobile Number (if different)

Contact Email:

*

If you have any special requirements (e.g. access/medical/dietary) please state here:

Total number of people you are booking onto course (including yourself):

1
2
3
4

*

Group Bookings

If you are booking for people in addition to yourself, please complete the following section:

Applicant 1:

Name:

Job Title:

Special Requirements:

Applicant 2:

Name:

Job Title:

Special Requirements:

Applicant 3:

Name:

Job Title:

Special Requirements:

Payment Details

If payment is required for the course you have chosen please complete the following section:

I wish to pay by cheque* **
Please invoice my school / organisation **

* cheque payment details will be sent to you once booking is confirmed

** for all courses organised by Northumbria University, payment can only be accepted by debit or credit card over the phone or in person at one of the University sports centres.

Invoice Contact Name and Address (if different from above):

Line Manager Name:

(if required)

Line Manager Job Title:

(if required)

I confirm that I have read the Terms & Conditions

*