* 1. £200 - this allows your organisation to send 2 members of staff to the next 3 ALC events over 2016-17. Additional staff can attend at half the non-members rate.

Your organisation

* 2. Name and job title of 1st rep
(note that anyone from the organisation can attend our events - but we like to have named representatives to contact)

* 3. Email address

* 4. Name and job title of 2nd rep

* 5. 2nd rep's email address

* 6. Name, address and email for invoicing 

* 7. Do you have a particular areas of interest within arts, creative and cultural learning?

* 8. Are there any themes that you would like to see as the focus of an ALC event? Name up to 3. If you would like to recommend particular speakers on these themes, please mention them here.

* 9. Do you have a venue that could be used for ALC events, free or at a subsidised cost? (ALC is able to pay for refreshment costs)

* 10. Would you like to be considered for the ALC Executive? Info at http://artslearningconsortium.org.uk/about/executive/