Dorset Rusty Musicians 2013 Booking Form Please complete one form per person in block capitals


Name:................................................................................... Telephone:............................................................................ Email:.................................................................................... Instrument:................................................... Grade:............ Age Group: Under 16


Adult:


Please indicate which music-making days you wish to attend. The cost includes music-making days plus rehearsal day and concert. Please tick which sessions you are planning on attending.


Music-Making Days Sunday 21 April Sunday 19 May Sunday 2 June &


Percussion Day Rehearsal Day


& Concert


I wish to pay by cheque (made payable to BSO)


I wish to pay by credit/debit card (Visa/Mastercard/Delta)


Sunday 16 June £.............. £..............


Name of Cardholder:............................................................................................... Card Number:


CVV Number: Expiry Date: Please return this form (with cheque if applicable) to:


Linda Higson (Project Manager), Dorset Rusty Musicians, BSO, 2 Seldown Lane, Poole, BH15 1UF For any enquiries, email lhigson@bsorchestra.co.uk or telephone 01202 644707


/ Sunday 5 May Sunday 12 May


Address:........................................................................... ......................................................................................... ............................................. Post Code:..........................


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