Colleague Discount Form
Branch
*
Please Select
ALDRIDGE 4029 NW
ALLENTON 4100 NE
ARNOLD 4062 NE
ATHERSTONE 4101 SE
BECCLES 4102 SE
BEESTON 4032 NE
BILSTON 4022 SW
BLOXWICH 4002 NW
BROWNHILLS 4003 NW
BURTON 4065 NW
CANNOCK 4004 SW
CASTLE DONINGTON 4103 NE
CHASE TERRACE 4005 NE
CHELMSLEY WOOD 4018 NW
CHELTENHAM 4078 SW
CHIPPING NORTON 4073 SW
CINDERFORD 4070 SW
CODSALL 4037 NW
COVENTRY 4007 SE
COVENTRY CHEYLESMORE 4118 SE
DERBY 4034 NE
DISS 4104 SE
DUDLEY 4091 SW
ERDINGTON 4105 NW
EVESHAM 4081 SW
FINCHFIELD 4093 NW
FRANCHE 4038 SW
FROME 4041 SW
GLENFIELD 4106 SE
GLOUCESTER 4071 SW
GRANTHAM 4122 NE
HALESOWEN 4090 SW
HAWKS GREEN 4008 NE
HEADINGTON 4068 SE
HUCKNALL 4049 NE
IBSTOCK 4107 NW
ILKESTON 4063 NE
KENILWORTH 4119 SE
KIDLINGTON 4067 SE
KINGS LYNN 4108 SE
KINGSWINFORD 4010 SW
LEAMINGTON SPA 4117 SE
LICHFIELD 4027 NE
LOWESTOFT 4109 SE
LYDNEY 4069 SW
MARCH 4115 SE
MARKET DEEPING 4110 SE
MARKET HARBOROUGH 4061 SE
MELKSHAM 4043 SW
NEWARK 4121 NE
NOTTINGHAM 4035 NE
OAKHAM 4111 SE
PERSHORE 4120 SW
SEDGLEY 4031 SW
SOLIHULL 4016 SE
STAFFORD 4089 NW
STOURPORT 4015 SW
STRATFORD UPON AVON 4116 SE
STREET 4044 SW
SUTTON COLDFIELD 4011 SW
SWINDON 4075 SW
TAMWORTH 4076 NE
THAME 4072 SE
THETFORD 4113 SE
UTTOXETER 4040 NW
WALSALL 4039 NW
WARMINSTER 4045 SW
WEDNESBURY 4017 SW
WHETSTONE 4114 SE
WOLVERHAMPTON 4021 SW
WORCESTER 4082 SW
VCE ONLINE 4401
VCE HW 4402
PTA 4060
Own Branch
AGENT / MCT/ Number
*
PLEASE ENTER THE FULL BOOKING NUMBER
AMS Booking Reference
*
PLEASE ENTER THE FULL BOOKING REFERENCE
Midcounties Colleague Name
*
Membership Number
*
Is this an CEC Colleague Discount Request
*
YES
NO
Has the CEC Colleague Policy been followed?
TRAVEL COLLEAGUES ONLY - Do you require the Commission to be reduced ?
*
Please Select
YES
NO
Travel Colleague Discount to be applied £
This ONLY applies for Travel Colleague Bookings , if commission has not been applied to Tarsc File
Total Cost of holiday to customer after discount (Excluding Midcounties/CEC colleague Discount)
*
Midcounties Colleague Discount to be applied £
*
This is the amount of Midcounties Colleague Discount to be applied to the Booking. (For Example 10% up to £XXX)
Is this a Co-op Holiday Booking
Please Select
YES
NO
Any other notes -
Please enter how much the colleague has used and is now requesting
Please enter the email address you would like to receive a copy of this form to for your records. Once received please print and sign keep for your records
E-mail
*
Issued 31.07.23
Submit
Should be Empty: