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PLANET
EARTH EDUCATION |
The Nature of the Stars 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 £ 70 £120
Please include your 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 :
Planet Earth, 45 willow Avenue, Middleton, Manchester, M24 2HE.