Session Title:	Licensing Board Members Session

Council Information
Local Authority:
Contact: Making the booking	1st Name:
Surname:
Job Title:
Phone Number – Office:
Phone Number – Mobile:
Email address:
Invoice: Purchase Order Number: Charges per candidate: £495 (+ additional charges if agreed)
Invoice: Send to name & email address:
Date of Training:	Option 1:
Option 2:
Option 3:
Do you wish the training and exam to be conducted: Online. In person. Please note that in person training will incur travel charges for the trainer if need be.)
Does the candidate require any special adjustments to attend the training or sit the exam? If so, we will come back to you to discuss.

Licensing Board Member Registration Data
First Name	Surname	Email address	Previous Board Member? Y/N

Return completed form to:

training@alcohol-focus-scotland.org.uk