| Name of Group / School / Organisation |
|
| Address |
|
| Postcode |
|
Country |
|
| E-mail |
|
Telephone Number |
|
| Date and Time of visit |
/
/
:
|
| Leave time |
:
|
| Contact name / Group leader |
|
| Number of adults |
(Aged 18 or over) |
Number of young people in full-time education |
(Aged 0-15)
(Aged 16-18)
|
| Year Group (if applicable) |
|
| Academic subject |
|
Level and type of institution
(if relevant) |
Please state level
|
|
Please state type of institution
|
Museums to be visited
* Wellcome Museum only available to Medical Professionals or Medical Students
(Opening hours: Hunterian | Wellcome)
|
Hunterian Museum |
Wellcome Museum *
(Fee Information) |
| Do you wish to book a tour of the Hunterian Museum? (fee applies) |
30 minute introduction £100/£75 + VAT
45 minute specialist tour £130/£97.50 + VAT
No thanks
Other, please state:
|
| Are you attending a workshop event? |
Please provide details
|
| Any special requirements? (e.g. access) |
|
| Please add my details to your mailing list |
Yes
No
|
|
