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* 1. Name

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* 2. Job Title / Student

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* 3. Area of research

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* 4. School / Department

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* 5. Institution

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* 6. Email Address

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* 7. I'm interested in finding out more about:

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* 8. I'm interested in the following training courses

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* 9. I would like to sign up to the Beltane Email list to hear more about Public Engagement Opportunities and training.

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* 10. Any other comments or questions?

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