EmailMe Form - Brexit Seminar:

Please reserve me a
place(s) on the following event: *

TBC June 2019 - Leeds

Delegate Name *

First Last

Position in Company: *

Additional Delegate Name 2

First Last

Position in Company:

Additional Delegate Name 3

First Last

Position in Company:

Company Name *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Telehone Number *

Email *

The cost of the event is:

£40 (excluding VAT) Regular Customers / Chamber Members

£60 (excluding VAT) Non-Regular Customers / Non-Chamber Members *

Please invoice me at the address above

Please contact me to pay by Credit/Debit card

Please invoice me at an alternative address (please supply)

Dietary requirements:

Any other comments:

Image consent

We occasionally take photographs at events. Kindly tick this box to give permission for your image to be used in future marketing materials on these occasions.

Second option

Third option

How did you hear about the event? *