Parkstone United Reformed Church – 16 Commercial Road Poole – BH14 0JW

I am interested in attending this event:

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• No
• Maybe

I cannot attend this event and would like to be informed of future events:

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to am

I am attending:

• As an individual
• As a representative of…(enter below)

As a representative of… (if applicable above)

I am interested in making a short presentation about the work of my

• organisation (10-15 minutes)…
• Website details (if any)...(enter below)

Website details (if any)... (if applicable above)

Do you have any access or support needs?

(NB The Dickinson Hall is only accessible by steps (approx. 6 steps)

Name *

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Thank you for your interest.

Marylyn

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