Devon Welfare Rights Unit

BOOKING FORM - PLEASE USE ONE FORM FOR EACH DATE

Please enter your details on the form below - these details are for your confirmation letter, and are essential to our funding.

Your contact email address:
Your contact telephone number:
Course Date:
Course Title:
If applying to a Level 2 or 3 course, please say if you have Completed Benefits Signposting		Yes No
Name of your organisation:
Address of your organisation:
In which part of the South West is your client base?:
Full names of participants & email addresses:


Please tick the category that best describes your organisation:
Health	Yes	DCC - Social Services	Yes	CAB	Yes
Private	Yes	DCC - Other	Yes	Housing Association	Yes
Statutory	Yes	District Council	Yes	Voluntary	Yes

Please refer to the table on the last page of the training schedule and state which district and fee you should be paying, or refer to www.dwru.org
District
Fees:

NB: Confirmation e-mails are sent within 4 weeks of the training day; If a course is full, you will hear immediately. All venues offer disabled access. Please note, we do not provide lunch.

Please tick if any of these are appropriate to you.......
Large Print Required	Yes No	Will bring a facilitator	Yes No	Other Needs - please state:
Braille Pack Needed	Yes No	Disabled Parking Space Required	Yes No
Induction Loop User	Yes No	Wheelchair User	Yes No


Devon Welfare Rights Unit Suite 2, Quintana Gate, Bartholomew Street East Exeter EX4 3BH			Tel: 01392 223827 Fax: 01392 223848 Email: dwrutraining@citizensadvice.org.uk

Please enter your details on the form below - these details are for your confirmation letter, and are essential to our funding.