EmailMe Form - Community of Change Residential Event

Local Authority and organisation members are entitled to 2 free places. Any additional places for members and for non members are subject to a fee (£400+VAT) & availability. A booking form must be completed for each place required.
Name of Local Authority / Organisation *
Is your organisation currently a member of In Control? *
Yes
No
Delegate name *
Prefix First Last
Job Title *
Delegate Email address *
Do you require overnight accommodation? *
Tuesday 6th November 18 (DB&B)
None required
Please indicate any special dietary or access requirements here - if none please enter none: *
If you are not a member of In Control, or you are a member wishing to purchase an additional place we will need to invoice you prior to the event however please note that there are a limited number of places available and additional places will only be allocated once all members have had the chance to book. Please provide details below:
Do you need an invoice? *
If yes, please provide the name of person to send the invoice to and either email or postal address
Purchase Order number:
Name of person making the booking *
Prefix First Last
Email Address: *
Contact number: *
Date *
DD / MM / YYYY
Please note that cancellations made within 14 days prior to the event may incur a cancellation fee.
Places will be confirmed by confirmation email from the event coordinator.