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SURREY WELFARE RIGHTS UNIT COURSE BOOKING FORM

Please complete for each participant and each course.

Course:
Date:
Venue:
Contact Details
Name:
Position:
Organisation:
Address:
Work Tel No: E-mail:	(Joining Instructions will be sent by e-mail)
Home Tel No:	(For Emergency Contact)

Address to which you would like joining instruction sent (if different):

Additional Requirements:

Vegetarian?
Other? (please specify):

Booked by:: Date:

Any special requirements regarding access etc. (wheelchair access,parking,accompanying carers,hearing loop etc..)

Our organisation does not subscribe and:  (please tick only one of the following)

A voluntary / community / faith organisation with less than £50k gross annual income

A voluntary / community / faith organisation with less than £200k gross annual income

A voluntary / community / faith organisation with over £200k gross annual income

Any other organisation

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Copyright © Surrey Welfare Rights Unit 2004
Charity registration number:- 1062826