Booking Form (1)
2
Booking form Date: Monday, 27 th June 2016 Event name: Tackling the inequality – cancer screening and learning disabilities. A sharing and learning event Time: 9.30 – 16.00pm Venue: The Beacon, Westgate Rd, Newcastle, NE4 9PQ (please note the venue change from the hold the date invites) Please fill out the form below and return it to [email protected] please note there is a limited capacity and you will be emailed confirmation of your place. Name Job title Email Telephone number Organisation Any additional requirements i.e. Dietary requirements For individuals who would like to car share please complete the below. Prior to the event we will email round a list of
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Booking Form
Transcript of Booking Form (1)
Booking form
Date: Monday, 27th June 2016 Event name: Tackling the inequality – cancer screening and learning disabilities. A sharing and learning eventTime: 9.30 – 16.00pmVenue: The Beacon, Westgate Rd, Newcastle, NE4 9PQ (please note the venue change from the hold the date invites)
Please fill out the form below and return it to [email protected] please note there is a limited capacity and you will be emailed confirmation of your place.
Name
Job title
Telephone number
Organisation
Any additional requirements i.e. Dietary requirements
For individuals who would like to car share please complete the below. Prior to the event we will email round a list of delegates willing to car share in your area
for you to arrange.
Would you be willing to car share?Are you be able to be a driverWhere would you be travelling from?
