'Brexit and You' event 15 March 2017 - Registration

Wednesday 15 March 2017
5.30pm - 8:00pm including buffet supper
Newark Showground, Newark NG24 2NY

Organisation details

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* Organisation details

Business Name

Post Code

Delegate 1

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* Delegate 1

Name

e-mail address

Delegate 2

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* Delegate 2

Name

e-mail address

Delegate 3

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* Delegate 3

Name

e-mail address

Delegate 4

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* Delegate 4

Name

e-mail address

We would like to share your contact details between the four partners hosting this event for follow up purposes. If you are happy with this please tick the box below.

Question Title

* We would like to share your contact details between the four partners hosting this event for follow up purposes. If you are happy with this please tick the box below.

Yes - happy to have my information shared

Please provide a telephone contact number - this will only be used in an emergency and not passed on to third parties.

Question Title

* Please provide a telephone contact number - this will only be used in an emergency and not passed on to third parties.

Telephone number

Please check your details and click on the 'Register' button below. You will receive confirmation within two working days.