SHFT Stakeholder Event - Carers Together - Hampshire, Portsmouth and Southampton

Southern Health Foundation Trust
Stakeholder Event - Friday 25th March 2022
Booking Form

You may use this form to book places for up to 2 people.

Attendee 1 Details

* Indicates required field

Name *

First

Last

Organisation & Job Title (If Appropriate) *

Postcode *

Email *

Phone Number *

Any Special Dietary Requirements? *

To comply with Fire Safety Regulations, the Crosfield Hall requires us to fill out a Personal Emergency Evacuation Plan (PEEP) for each disabled person. For the purposes of the PEEP, a disabled person is defined as someone who would be unable to evacuate the building without assistance.

To help us with this, could you please provide whether or not you have a disability? *

Yes No

Attendee 2 Details

Name *

First

Last

Organisation & Job Title (If Appropriate) *

Postcode *

Email *

Phone Number *

Any Special Dietary Requirements? *

To comply with Fire Safety Regulations, the Crosfield Hall requires us to fill out a Personal Emergency Evacuation Plan (PEEP) for each disabled person. For the purposes of the PEEP, a disabled person is defined as someone who would be unable to evacuate the building without assistance.

To help us with this, could you please provide whether or not you have a disability? *

Yes No

Submit