Please complete the form below if you wish to apply for a place on this training course taking place at Disability North, The Dene Centre, Gosforth, Newcastle upon Tyne, NE3 1PH on the 29 November 2018 at a cost of £110+vat per person (lunch included) from 9.30am - 4.00pm.

PLEASE NOTE ALL BOOKINGS MADE BETWEEN 23 OCTOBER AND 1 NOVEMBER WILL BE CONFIRMED ON 1 NOVEMBER

Cancellations must be made in writing before 19 November 2018 and will be subject to a 50% administration fee. Refunds for cancellations are not available after this date.

Question Title

* 1. Please state how many places you wish to apply for

Question Title

* 2. Please supply name(s) and job titles of delegate(s):

Question Title

* 3. Please supply addresses of delegates:

Question Title

* 4. Please supply a contact telephone number:

Question Title

* 5. Please supply your e-mail address:

Question Title

* 6. Do any of the delegates have any additional requirements (e.g. Dietary, Large Print Format, etc.)

Question Title

* 7. Please supply the name and contact details of the individual to invoice at you company/organisation.

T