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REGISTRATION FORM FOR ASSOCIAZIONE ITALIANA SOMMELIER {dal 1965}

PROFESSIONAL SOMMELIER DIPLOMA QUALIFICATION COURSE

 

FULL NAME………………………………………………………………………………………………………………………....

 

ADDRESS ……………………………………………………………………………………………………………………….…..

 

POST CODE ……………………………………………………………………………………………………………..………..

 

DATE OF BIRTH …………………………………………………………………………………………….…………………..

 

MOBILE ………………………………………………………………………………………………………………….………..

 

EMAIL …………………………………………………………………………………………………………………….………..

 

OCCUPATION …………………………………………………………………………………………………………………..

 

WORK ADDRESS ……………………………………………………………………………………………….……………..

 

WORK TELEPHONE NUMBER …………………………………………………………………………………………..

EMERGENCY CONTACT NAME AND MOBILE

………………………………………………………………………………………………………………………………………..

I would like to receive emails from UKMSA                          Y                                              N

Where did you hear about the course?

……………………………………………………………………………….……………………………………………………..

The undersigned agrees to the recording, storage and processing of personal data for administrative, operational, managerial and accounting purposes by AIS/UKMSA and the inclusion of such, in the Association archive.

Date …………………………………………………………………….……………………………………………………..

Signature ……………………………………………………………………………………………………………………..

Send to : thesommelieruk@gmail.com

UKMSA 2022 Office: Kimberley, Victoria Road, Llanwrtyd Wells, Powys  LD54SU

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