Standing Together Training Booking Form CAVSA 5th June.doc

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Booking Form

Domestic Abuse: How Can We Help?

5th June
10am – 2.30pm


To Register: Please submit your completed booking form to:

POST: Training Admin, Standing Together Against Domestic Violence,
Room 44d, The Polish Centre, 238-246 King Street, London W6 0RF
FAX: 020 8748 5921
EMAIL: l.burtenshaw@standingtogether.org.uk
ENQUIRIES: 020 8748 5717

DELEGATE DETAILS

1st Delegate

Name Title
Job Title
Organisation
Address
Postcode
Email
Telephone Fax
Dietary/Access requirements

2nd Delegate

Name Title
Job Title
Organisation
Address (if different from above)
Postcode
Email
Telephone Fax
Dietary/Access requirements

3rd Delegate

Name Title
Job Title
Organisation
Address (if different from above)
Postcode
Email
Telephone Fax
Dietary/Access requirements