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CDP Workshop Booking Form
If you’re interested in one of our CPD workshops or would like additional details, please complete the form below, and a member of the Jiraffe team will be in touch.
*
1.
Title
(Required.)
Dr
Master
Miss
Mr
Mrs
Ms
Proff
Other (please specify)
*
2.
First Name:
(Required.)
*
3.
Last Name:
(Required.)
*
4.
Contact Type:
(Required.)
Physiotherapist
Occupational Therapist
Carer
End User
Parent
Key Worker
Therapy Assistant
Doctor
Headteacher
Business Manager
Purchaser
Purchasing Manager
Sibling
Solicitor
Stores Manager
Teacher
Teaching Assistant
Therapist
Nurse
Other
Other (please specify)
*
5.
Email Address:
(Required.)
*
6.
Business/Organisation name
(Required.)
7.
Business/Organisation Address:
Street:
Town/City:
County:
*
8.
Postcode
(Required.)
*
9.
Phone Number:
(Required.)
*
10.
Which Workshop(s) are you interested in, or would you like to book?
(Required.)
Every Hour Matters: 24-hour Postural Care in Paediatric Physical Disability
Fitness & Fun: The Cycling Solution (not available in Ireland)
Night-Time Positioning for Children with Complex Physical Disabilities
Sit With Me: Making Adaptive Seating Child-Centred
Stand With Me: The Supported Standing Journey Through the Ages
Require additional details
*
11.
Are you an existing Jiraffe customer
(Required.)
Yes
No
12.
Notes/Questions
*
13.
Would you like to receive email updates focused around products, competitions and clinical research? By confirming 'Yes' you agree to be included on a distribution list to receive marketing updates from Jiraffe which you can unsubscribe from at any point in the future.
(Required.)
Yes
No
