ITA Leadership Conference 2019 Booking Form

Thank you for booking a place on the Isle of Wight Leadership Conference 2019. Please complete the following questions.

Question Title

* 1. Contact Details

Name

Company

Address

Address 2

City/Town

Postcode

Email Address

Phone Number

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* 2. Role

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* 3. Requirements

Hearing Loop

Braille

Access

Audio

None

Other (please specify)

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* 4. Dietary Requirements

Vegetarian

Vegan

None

Allergy (please specify)

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* 5. Contact details for invoicing

Name

Role

Email Address

Phone Number

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* 6. Permission received to attend event from Line Manager

Yes

No

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* 7. I understand that by completing this form, I agree to attend the above named event and to pay the required charge. I understand that I must inform the Island Teaching Alliance in writing, if I am unable to attend the above named event. I understand that cancellation up to four weeks in advance of the event will incur a 50% refund and beyond this a full charge will be made.

Agree