Thank you for booking your place on our 2011 Rural Conference. We hope its going to be an informative event and an opportunity for you to meet colleagues, share news and expertise.

This third Rural Minds conference will address the impact of recent and divergent policy changes within both England and Wales on people facing mental health problems living in rural areas as well as showcasing examples of good practice in service delivery.

The conference will run over 24 hours and will include keynote speakers from Mind and the third sector, together with workshops around rural policy and practice as well as practical wellbeing sessions. There will also be a marketplace with stalls from a range of Mind’s departments including Policy and Campaigns, Specialist Support and the Local Influencing Project.

* Please provide the following details:

* Is your organisation one of the following:

* Please tick the following statement(s) that applies to you:

* Do you have any dietary requirements:

* Please detail any accessibility requirments you may have:

* The delegate fee depends on whether you are attending as an individual or on behalf of an organisation, and whether you require overnight accomodation.

If you are attending on behalf of an organisation your fee will also depend on the income of the organisation and whether it is a voluntary sector or a public sector organisation.

Please indicate which fee is applicable to you:

* Mind will be running a mini bus service from Darlington train station to the venue, would you be interested in using the mini bus service?

* There will be travel bursaries available to help cover part, or the total, travel costs for people who would otherwise be unable to attend.

The bursaries are dependant on you either being an individual NOT associated with an organisation or your organisation's income being below £150K.

Please indicate below if you think you are eligible and are interested in receiving a bursary towards your travel costs.

Unfortunately there is a limited fund available, expressions of interest will be dealt with on a first come, first served basis.

Bursaries will be allocated on Friday 5 August 2011 therefore all expressions of interest (which is done via this booking form) need to be registered before then.

You will be contacted regards your request for a travel bursary.

* Please provide your contact details