The Next Chapter - booking form for professionals - Surrey Coalition of Disabled People

The Coalition: The Next Chapter – booking form for professionals

Attendance

Name(Required)

First Last

Phone number(Required)

Email address(Required)

Address(Required)

Street Address Address Line 2 City County Postal Code

Attendance(Required)

I will attend in person

Wheelchair information

Will you be using a wheelchair on the day?

Manual

Electric

Neither

Other requirements

A Loop System, BSL interpreter, Makaton interpreter, speech to text reporting and Personal Assistance will be available on the day. Please let us know if you have any other needs in the space below.

I will be bringing a PA(Required)

Yes

My other accessibility and access needs are:

I've not been out for ages; it was really lovely to get out.

- Get More Active Get Together attendee

Simple acts of kindness that can transform somebody's day to day life

- Tech to Community Connect member

Contact Information

Address

Surrey Coalition of Disabled People
Astolat, Coniers Way
Burpham, GU4 7HL

The Coalition: The Next Chapter – booking form for professionals

Attendance

Wheelchair information

Other requirements

Contact Information

Address

Email

Call or text

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