Hesley Group Autism Event - Online Booking Request Form

PLEASE COMPLETE ONE FORM PER PERSON WISHING TO REQUEST A PLACE.

We will endeavour to confirm whether you have been allocated a place as soon as we can by EMAIL and TEXT therefore by submitting your request for a place you are consenting to us contacting you about this event via those methods. 

Please note that previous events have received an overwhelming number of requests for places so please bear with us whilst we process requests and confirm those who are successful.

REQUESTING A PLACE WILL NOT AUTOMATICALLY BOOK YOU A PLACE ON TO THIS EVENT - PLEASE ENSURE YOU HAVE RECEIVED A CONFIRMATION EMAIL FROM US PRIOR TO ATTENDING.

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your current Job Title?

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* 4. What is the name of the organisation that you currently work for?

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* 5. Please select the geographical area that you work within from the list below.

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* 6. What is your mobile contact number? (only event information texts will be sent to this number)

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* 7. At what email address would you like to be contacted?

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* 8. Do you agree to Hesley Group sending you further emails?

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* 9. Why is this event of interest to you?

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* 10. Do you have any special dietary requirements, and if Yes what are they?

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* 11. Do you have any specific access requirements, and if Yes what are they?

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* 12. Have you attended a Hesley Group free event before?

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* 13. Where did you first find out about this event?

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