Disability Alliance Training Booking Form
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1. Disability Alliance Training Booking Form
For training enquiries email mholland@disabilityalliance.org. Telephone 020 7247 8776 (Voice and Minicom).
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1
. Delegate's name
Delegate's name
2
. Position
Position
*
3
. Organisation
Organisation
*
4
. Member of Disability Alliance
Member of Disability Alliance
Yes
No
*
5
. Address
Address
*
6
. Telephone
Telephone
7
. Fax
Fax
8
. Email
Email
*
9
. Date of training
Date of training
Wednesday 17th November 2010 - London
Thursday 27 January 2011 - Wrexham
*
10
. Payment
Payment
Please invoice me
11
. Special needs
Special needs
None
Course Materials in Large Print
Loop system
Wheelchair user
12
. Dietary requirements
Dietary requirements
13
. Name of personal assistant/support worker (if attending)
Name of personal assistant/support worker (if attending)
14
. Personal assistant's/support worker's dietary requirements
Personal assistant's/support worker's dietary requirements
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