Appendix 6 - Training Event Booking Form Template

To be held at: (insert address of training venue and date of event)Booking Form

Please complete one booking form (photocopy as required) for each person who wishes to attend and return to (insert contact details of person in charge of registration) by (insert date on which booking form must be returned. Provide postal, telephone and email contact information)

Name: ________________________________________________________

Title: _________________________________________________________

Postal Address: ________________________________________________

______________________________________________________________

______________________________________________________________

Telephone Number: ____________________________________________

Email: ________________________________________________________

Please tick the following where applicable:

• I require a sign language interpreter
• I require a loop system
• I require a speed text operator
• I will be accompanied by a PA
• I will be bringing my guide dog
• I require accessible parking facilities

Special dietary requirements;

Please specify: _____________________________________________

________________________________________________________

Any other requirements.

Please specify: _____________________________________________

_________________________________________________________

Require materials in an alternative format: Please indicate

• Braille
• Large Print
• Easy to read
• Disk (3.5 floppy)
• CD

If you would like this form in an alternative format (list formats available/available upon request) please contact (Insert contact details of person in charge of information provision) by (insert date on which booking form must be requested and provide postal, telephone/minicom and email contact information)