Challenging Society? - booking form | NEP Yorkshire and Humberside

Challenging Society? - booking form

Use this form to book a place on the Challenging Society? Conference at Bradford University on 23rd September 2011

Your name: *

Your organisation: *

Organisation you work for or will be representing at this event

Position: *

Your position within the organisation (if applicable)

Your email: *

Phone number: *

Please provide a phone number, particularly if you do not have an email.

Conference Fee: *

Unwaged and local activists £30

Employed/ self employed and paying for yourself £45

Small community or voluntary sector organisation £55

Large community, voluntary, public and private sector organisation £60

The Conference is subsidised by the University of Bradford to keep the costs as low as possible to ensure good accessibility. Please select the appropriate fee category

Early Bird Discount:

I am booking before 25th August and would like the £5 Early Bird discount

Bursary Application:

I would like to apply for a Bursary towards the Conference Fee

Please only select this option if you are unpaid.

Payment Method: *

I will send a cheque when I receive notice of confirmed place

I will pay by BACS when I receive notice of confirmed place

Please send me an invoice to the address shown

Please select payment method

Your address (and Invoice address if applicable): *

Other information:

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Challenging Society? - booking form

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