Safeguarding Adults - Booking Form

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 9 February 2017 at a cost of £110+vat per person (lunch included) from 9.30am - 4.00pm.

Cancellations must be made in writing before 2 February 2017 and will be subject to a 25% administration fee. Refunds for cancellations are not available after this date.

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

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

* 3. Please supply addresses of delegates:

* 4. Please supply a contact telephone number:

* 5. Please supply your e-mail address:

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

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

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