01204 417372 07507 893907 www.c-t-c.org.uk BOOKING FORM Please complete and forward with your payment to: Ian Carruthers Counselling & Training Centre c/o 33 Hilton Avenue Horwich, Bolton BL6 5RH Name of Course: ‘An Introduction To Recognising and Working With Victims/Survivors Of Childhood Sexual Abuse’ Date: 20th March 2010 Venue: Lever Park School, Stocks Park Drive, Horwich, Bolton BL6 6DE Cost: £50 Cheques to: Counselling & Training Centre Name: Address 1: Address 2: Address 3: Post Code: Telephone No: E-mail: Dietary requirements: Yes/No* Details: