Course details TRAVEL ARRANGEMENTS UNTIL A PLACE HAS BEEN CONFIRMED. Course date 26th October 2017 Monitoring Course title SE Region Retired Members Network Day To help us work towards fair representation, please answer the following questions: Do you identify yourself as being: Course code (if known) n/a Closing date for the course 12th October White British Irish Your details Any other White background Male Female race White & Black Caribbean Surname White & Asian First name Any other Mixed background Asian or Membership no. Asian British Indian Branch Pakistani Service group (e.g Health, Local Gov) Any Asian background Black & Black British Caribbean Address for correspondence African Any other Black background Chinese or Contact no. other ethnic Chinese Mobile group Any other ethnic background Please provide your email address below so we can send further information by email: ---------------------------------------------------------------- Email All applications must ask their Branch Secretary to complete this section. Facilities This application is supported by the Branch. We Do you have special dietary needs? Yes / No agree to cover the £25 delegate rate and any Are you disabled? Yes / No travel costs associated to this event. Lunch and Do you have any access needs? Yes / No refreshments will be provided at the event. Do you need assistance with child/dependent care to attend Signed Date this course? Yes / No If you have answered yes to any of the Branch position please give details: Return to: _______________________________________ Vanessa Baquer UNISON South East, Ranger House, _______________________________________ Walnut Tree Close, Guildford, Surrey GU1 4UL Fax to: 570271 PLACES CANNOT BE GUARANTEED. Email to: THEREFORE YOU ARE ADVISED NOT TO MAKE
Course details Course date 26th October 2017 Course title SE Region Retired Members Network Day Course code (if known) n/a Closing date for the course 12th October Your details Male Female Surname First name Membership no. Branch Service group (e.g Health, Local Gov) Address for correspondence Contact no. Mobile Please provide your email address below so we can send further information by email: Email Facilities Do you have special dietary needs? Yes / No Are you disabled? Yes / No Do you have any access needs? Yes / No Do you need assistance with child/dependent care to attend this course? Yes / No If you have answered yes to any of the please give details: _______________________________________ _______________________________________ PLACES CANNOT BE GUARANTEED. THEREFORE YOU ARE ADVISED NOT TO MAKE TRAVEL ARRANGEMENTS UNTIL A PLACE HAS BEEN CONFIRMED. Monitoring To help us work towards fair representation, please answer the following questions: Do you identify yourself as being: White British Irish Any other White background race White & Black Caribbean White & Asian Any other Mixed background Asian or Asian British Indian Pakistani Any Asian background Black & Black British Caribbean African Any other Black background Chinese or other ethnic Chinese group Any other ethnic background ---------------------------------------------------------------- All applications must ask their Branch Secretary to complete this section. This application is supported by the Branch. We agree to cover the £25 delegate rate and any travel costs associated to this event. Lunch and refreshments will be provided at the event. Signed Date Branch position Return to: Vanessa Baquer UNISON South East, Ranger House, Walnut Tree Close, Guildford, Surrey GU1 4UL Fax to: 570271 Email to: