PLEASE COPY AND PASTE INTO A WORD DOCUMENT, TYPE IN YOUR DETAILS

AND EMAIL TO HMAMIG@GMAIL.COM

OR POST TO:
HMA, The Old Forge, Blanket Street, East Worldham, Hants GU34 3AG
I wish to book _____ places - HMA/CIM Members 25 ______ places - nonmembers 35
Membership number__________________________
Name: ____________________________________________________________
Position: __________________________________________________________
Company Name: ____________________________________________________
Address: __________________________________________________________
________________________________________________________________
Email Address: _____________________________________________________
If you are not a member of the HMA and would like to receive details of our
future HMA events and activities by email please tick here ______________
I enclose a cheque made payable to the HMA for the sum of _______
Or by credit card: Amex /Visa/Mastercard/Switch/Other for the sum of _______
Name on Card: _____________________________________________________
Address of Cardholder: _______________________________________________
__________________________________________________________________
Credit Card No: _____________________________ Security No: ______________
Expiry Date: ________________ Issue No/Start Date (Switch only): ___________
Signature: _________________________________________________________

Chartered Institute of Marketing Vat No. 302 2509 13