Consortium of Higher Education Support Services with Deaf Students Meeting - PRINTABLE BOOKING FORM


June 11th at The University of Wolverhampton
(11.00am - 4.00pm)


Personal details

Name:................................................................................................................................
Address:...........................................................................................................................
...........................................................................................................................................
Tel No: (work) ..................................................(home)...................................................
Fax No:..............................................................E-mail:....................................................


The meeting venue is accessible to wheelchair users and an enhanced hearing system (loop) will be provided. Please advise us of any individual requirements by ticking the boxes below and giving any further details. Every effort will be made to meet needs.

A sign language interpreter/lipspeaker/notetaker (please specify)

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Materials in Braille/audio tape/large print/computer disk (please specify)

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Reserved car parking space if you are disabled

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Place for personal assistant (please give assistant's name)

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Any other needs

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Payment

The fee for the full day is £20 or £10 for either the morning or afternoon sessions. If possible, please enclose payment with your booking.

· Please book ...........place(s) for the full day event on 11th June 2002

...........place(s) for the morning session (11.00 - 1.00)
...........place(s) for the afternoon session (2.00 - 4.00)

· I am enclosing a cheque/PO for £........…… made payable to: 'University of Wolverhampton'

OR

· Please send an invoice for £ .................. to:

...........................................................................................................................................

...........................................................................................................................................

...........................................................................................................................................

· Receipt (for fee(s) paid) required: YES/NO


Signed: ............................................................................................................................

Date: .............................................................................................................................

Please send completed registration forms, with cheques/postal orders by the:

7th June 2002

to:

Louise Rhodes
Manager - Communication Support Unit
Room MB106c
University of Wolverhampton
Stafford Street
Wolverhampton
WV1 1SB

NOTE: Further details (directions to venue; agenda etc) will be sent on receipt of booking form

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