ITA Leadership Conference 2019 Booking Form Thank you for booking a place on the Isle of Wight Leadership Conference 2019. Please complete the following questions. OK Question Title * 1. Contact Details Name Company Address Address 2 City/Town Postcode Email Address Phone Number OK Question Title * 2. Role OK Question Title * 3. Requirements Hearing Loop Braille Access Audio None Other (please specify) OK Question Title * 4. Dietary Requirements Vegetarian Vegan None Allergy (please specify) OK Question Title * 5. Contact details for invoicing Name Role Email Address Phone Number OK Question Title * 6. Permission received to attend event from Line Manager Yes No OK Question Title * 7. I understand that by completing this form, I agree to attend the above named event and to pay the required charge. I understand that I must inform the Island Teaching Alliance in writing, if I am unable to attend the above named event. I understand that cancellation up to four weeks in advance of the event will incur a 50% refund and beyond this a full charge will be made. Agree OK DONE