Anmälan till 5 dagars gruppledarutbildning med start I Tierp 23- 24 mars 2017 Namn:____________________________________________________________________________________ Befattning:_________________________________________________________________________________ Arbetsplats:________________________________________________________________________________ Kommun/landsting/organisation:______________________________________________________________ Mailadress:________________________________________________________________________________ Telefon arbetet:________________________________Privat:_______________________________________ Allergi/specialkost:__________________________________________________________________________ Namn:____________________________________________________________________________________ Befattning:_________________________________________________________________________________ Arbetsplats:________________________________________________________________________________ Kommun/landsting/organisation:______________________________________________________________ Mailadress:________________________________________________________________________________ Telefon arbetet:_______________________________Privat:________________________________________ Allergi/specialkost:__________________________________________________________________________ Namn på anmälare:_________________________________________________________________________________ Befattning:________________________________________________________________________________ Telefon:___________________________________________________________________________________ Mailadress:________________________________________________________________________________ Fakturaadress med referensnummer: __________________________________________________________________________________________ __________________________________________________________________________________________ Anmälan senast 27 februari 2017 till Ann Nilsson. För mer information kontakta: Ann Nilsson, kursledare [email protected] 0293 -21 90 18
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