Registration Form - UCL Fuel Alternative Professional Development Forum

Thank you for your interest in the UCL Fuel Alternative Professional Development Forum.
Please complete this form by 12pm, Wednesday 25th September to register for the events. We will get back to you shortly after the deadline to arrange payment to confirm your place.
If you have any specific questions about Forum or the events, please contact:
Irene Butera
irene@fueltheatre.com
1.Full name:(Required.)
2.Company / Organisation:(Required.)
3.Role / Job Title:(Required.)
4.Email address:(Required.)
5.Contact telephone number:(Required.)
6.How did you find out about the UCL Fuel Alternative Professional Development Forum?(Required.)
7.Why do you want to get involved with the UCL Fuel Alternative Professional Development Forum?(Required.)
8.This is programme includes a ticket to attend a performance of Nowhere by Khalid Abdalla at Battersea Arts Centre, produced by Fuel.

Please select which performance date you would like to attend:(Required.)
9.This programme includes participation in a full-day event at UCL East Campus in London on Thursday 7th November, 10am-6pm.

Please confirm you are able to attend:(Required.)
10.Do you have any dietary restrictions or requirements?(Required.)
11.Please give us details of your dietary requirements:
12.Do you have any allergies?(Required.)
13.Please provide details of your allergies:
14.Do you have any access requirements?(Required.)
15.Please provide details of your access requirements:
16.The cost to attend the event is £1,500 + VAT

Please let us know who we need to contact for billing:(Required.)
17.Please complete the Equal Opportunities Survey.

Select 'yes' below when this has been completed.(Required.)