You MUST complete all the fields marked with a red asterisk (*)

*Title: e.g. Mr, Mrs, Miss
*Full Name:	please provide your FULL name
*Address: (house number and street name)
Borough:
*Post Code:
*Telephone Number: (Mobile Number preferred)
Entering your mobile number will enable us to send you a text message to confirm your booking.
	Please select ONE red box from the list below (and select which NHS trust or London borough you work in if applicable): I work in the health care sector Which NHS Trust? .............. Please select below: Guy's and St Thomas' NHS Foundation Trust King's College Hospital NHS Foundation Trust Lambeth PCT Southwark PCT South London and Maudsley NHS Foundation Trust University Hospital Lewisham Lewisham PCT NHS London St Christopher's Hospice St Georges Healthcare NHS Trust Other If Other, please specify: I work in a school Which London borough is your school in?.......... Please select below: Lambeth Southwark Wandsworth Other If Other, please specify: I work in another sector Please state your employer:       Mon 11-12 Thurs 11-12
*Which day(s) will be must convenient for you to attend the briefing session?
*How did you hear about us:	Select an option: Access leaflet / flyer Browsing the internet A friend who is already attending workshops Flyer for UNISON members Nursing Adaptation Course Your child's primary school Other
If other then please specify:

 

We look forward to seeing you at the briefing session. Please note: Should you wish to join the Uni4U Project, you will need to provide a document of identification (ID). *Please indicate the type of ID you can provide. Select from the list below.

Please Select: UK passport EU passport National Insurance Number UK Residence permit Home Office document confirming my UK immigration status Non-EU Passport with visa

Click below to submit your booking