Registration Form
Care and Support for People with Complex and Severe Needs; Innovations and Practice
Event: Feedback Workshop
Date: Thursday 24 November 2011, 11.00am - 3.00pm
Organisers: Social Policy Research Unit (SPRU), University of York, and School for Social Care and Research
Venue: University of York, Alcuin Research Resource Centre (ARRC)
The workshop is free of charge
Title (Mr, Ms, Dr, etc.)
Name
*
First Name
Last Name
Organisation
*
Role in Organisation
Work email
*
Telephone number
-
Area Code
Phone Number
Workshop attendance
*
Yes, I will be attending.
I am providing details of another contact/organisation who may be interested in attending the workshop (please use the box below to provide further information).
Contact/organisation who may be interested (please include name, telephone number and email address, if possible).
Display area
Yes, I would like a spot in the display area (please use the box below to provide further information).
Display area information e.g.'s what you are bringing and how many copies.
Dietary requirements
Yes, I do have dietary requirements (please use the box below to provide further information).
Dietary requirements e.g. vegetarian.
Other requirements
Yes, I do have other requirements (please use the box below to provide further information or contact us using the details at the bottom of the form).
Other requirements e.g.'s access, communication, PA support.
Jenni Brooks
01904 321292
jenni.brooks@york.ac.uk
Kate Gridley
01904 321988
kate.gridley@york.ac.uk
Submit Form
Should be Empty: