Booking for East Durham Event 18th January 2012

1. About you/ your group or organisation

The event is for women activists who live or work in East Durham and/ or representatives of women’s organisations, voluntary organisations, community groups and Trade UnionsThe event is for women only.

Question Title

* 1. Are you (tick any that apply)?

A woman who lives or works in East Durham

A representative of a women's organisation

A woman representative of a voluntary organisation or community group

A woman Trade Union representative

A woman Councillor in East Durham

A woman involved in policy making from the public sector

Other

If other - please state

Question Title

* 2. Please provide your contact details

Name:

Organisation or group (if applicable):

Post Code:

Email Address:

Phone Number: