(Doulgas Baker.Com Bookstore)

'Little Elephant', High Road, Essendon, Hertfordshire, AL9 6HR, ENGLAND
Tel: +44 (0) 1707 646115, Fax: +44 (0) 1707 642341 douglasbaker@btinternet.com
<< Enrolment Form >>
Pay on-line (£50 UK Sterling) by completing this form.
(Your first lesson will be sent to you upon registration)
Payment for subsequent lessons will be due with return to us of lesson request form (included with preceding lessons). Each of the 24 lessons includes printed material and two audio cassettes. You will be required to purchase additional text books as required, but as a student of the correspondence course you will be entitled to a 20% discount of the normal selling price on all textbooks.

USER INFORMATION
Login Name (email address)
Password
BILLING INFORMATION
Title
First name
Last name
Address1
Address2
Town/City
County/State
Post/Zip Code
Country
Telephone (home)
PAYMENT INFORMATION
Card:
Card Number:
Expiration Date:
CSC number
Full Name on Card:
Amount to be charged:	£50.00 (UK Sterling)
Comments / Additional Info

<< Enrolment Form >>