March to save NHS bursaries on 4 June 2016

Please fill in your details so that we can keep you up-to-date and provide you with support.

Questions marked with * must be completed.

If you have any queries please contact health@unison.co.uk

We look forward to seeing you at the march.

UNISONs National Nursing & Midwifery Committee

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* 1. Please complete the following information

First name

Last name

UNISON membership number

Email address

Place of work/study

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* 2. Please select the region closest to you.

Eastern

East Midlands

Greater London

Northern

Northern Ireland

North West

Scotland

South East

South West

Wales/Cymru

West Midlands

Yorkshire & Humberside

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* 3. Funding requests for travel expenses to the march. Please note that funding is provided on a first-come, first-served basis and isn't guaranteed.

I do not wish to apply for funding for travel expenses

I would like to apply for funding for travel expenses

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* 1. Please complete the following information

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* 2. Please select the region closest to you.

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* 3. Funding requests for travel expenses to the march. Please note that funding is provided on a first-come, first-served basis and isn't guaranteed.

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* 4. How much will your travel cost?