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Accelerating Inclusion through Allyship
Application Form
Please complete this Application Form to Book your place
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1.
Delegate Details
(Required.)
Title:
First Name:
Surname:
Organisation Name:
Organisation Address (inc. postcode):
Email Address:
Phone Number:
Personal Assistant Contact Details, if applicable:
Please state any specific access, audio and/or visual, disability requirements
*
2.
What is your Job Title ?
(Required.)
*
3.
What are your areas of responsibility?
(Required.)
*
4.
Please confirm which cohort you would like to book on to
(Required.)
May 2023
January 2024
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5.
Booking Confirmation
The delegate fee is £1,500 plus VAT.
You must provide a purchase order number on this booking form to enable us to process your application. Once your place is confirmed, an invoice will be emailed to you and payment must be made before the start of the programme.
Note: Please ensure that a copy of your Purchase Order is emailed to finance@wmemployers.org.uk before the start of the programme
(Required.)
Please state your Purchase Order Number
Please provide an email address where we should send your invoice for payment
Please confirm whether member or non member
*
6.
Terms & Conditions
An email will be sent to your email address to confirm your booking application has been
received and that we have reserved you a place on your selected cohort
.
Once we confirm your place, an invoice will be sent to the invoice email address provided and
payment
should be made at least 5 working days before the start of the course to activate your access to the programme and delegate materials.
Full
joining instructions
will be sent to the delegate email address no later than 5 days before the programme start date or as soon as payment is made if less than 5 days before the programme start.
Cancellation Policy
All cancellations must be made in writing to info@wmemployers.org.uk and the following cancellation charges will apply.
Cancellation of a confirmed booking within 30 working days of the cohort start date will be charged at 50% of the fee.
Cancellation of a confirmed booking within 15 working days of the cohort start date will be charged at 100% of the fee.
(Required.)
Yes, I accept all Terms & Conditions
*
7.
Data Protection
Managing Your Information - Please read our
Privacy Notice
and give consent for your contact details to be used for the administration of this programme and related Inspire communications or activity.
(Required.)
Yes, I have read and understood how my contact details will be used.
*
8.
Evaluation and Feedback
We will be asking
all participants to provide feedback and participate in evaluation of these programmes.
(Required.)
Yes, I confirm that I am happy to participate in the evaluation process
*
9.
I confirm that all the information on this form is true, complete and accurate
(Required.)
Yes
No
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