DATE of VISIT: Please select the most suitable of the dates below.

Monday	Tuesday	Thursday	Friday
8th January	9th January	11th January	12th January
15th January	16th January	18th January	19th January
22nd January	23rd January	25th January	26th January
29th January	30th January	1st February	2nd February
5th February	6th February	8th February	9th February
12th February	13th February	15th February	16th February
19th February	20th February	22nd February	23rd February
26th February	27th February	1st March	2nd March
5th March	6th March	8th March	9th March
12th March	13th March	15th March
19th March	20th March	22nd March	23rd March
26th March	27th March	29th March	30th March
	3rd April	5th April
		12th April
	17th April	19th April	20th April
23rd April	24th April	26th April	27th April

Numbers for GOLF
Numbers for DINNER	(if different)
We agree to the BOOKING CONDITIONS stated above

THEN please send your DEPOSIT for £ with a copy of this Booking Form to The Secretary, Chippenham Golf Club, Malmesbury Road, CHIPPENHAM, Wilts. SN15 5LT