PilchConnect Seminar Registration Form (2)

PilchConnect Seminar Registration (2)

Seminar details
Note that this seminar series is only for not-for-profit organisations
Contact person's details
Please provide us with the details of the person who is making the registration
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Please let us know if you wish to be added to our mailing list
Organisation contact information
Please provide us with the contact details for your organisation
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If different from street address
Names of those attending
A maximum of 2 people per organisation
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Please set out any general questions you would like the presenter to consider
Please let us know if there are any special requirements you need to assist with your participation in this seminar e.g. food allergies, wheelchair access
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If you chose 'Other' please specify
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Please tell us the legal structure of your organisation?
If you chose 'Other' for organisation type please specify
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Hold down the 'Control' ('Ctrl') key if you wish to select more than one
If you choose 'Other' for principal activity please specify
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Please choose only ONE
If you choose 'Local' for geographic area please specify, e.g. western region
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e.g. membership fees, grants, fee-for-service
Content last updated: 30/03/10