GCSE Astronomy Enrolment Form

1.    Title        2.   Full Name    

3.    Date of Birth        4.    Gender    Male        Female   

5.    Address   

6.    Telephone Number   

7.    Usual Occupation      

                                                                                          UK         Overseas 

8.    Amount Enclosed              Payment in Full                      £150      £180 

        (please tick box)              First of two instalments            £76         £92 

                                                 First of four instalments        £39        £47 

                                                 First of eight instalments       £20         £24 

Please include your first payment with your enrolment.

Please make cheques and postal orders payable to Planet Earth

9.    Signature   

10.    Date          

11.    E-mail address 

Please forward Enrolment form and Remittance to :

 Planet Earth,  45 willow Avenue, Middleton, Manchester, M24 2HE.