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NAPA Life Story workshop Application form
Please complete the form fully
We will invoice NAPA Members at a rate of £25 per delegate
Please contact :
info@napa-activities.co.uk
with any questions
Many thanks
The NAPA Team
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Name of care setting:
*
Your answer
Organisation:
*
Your answer
NAPA Member *
*
Yes
No
Not sure * We will check and let you know
What is your membership number?
Your answer
Address - including postcode
*
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Telephone number:
*
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Email address for any queries
*
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Invoice address, if different to above:
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Email address for invoice:
*
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Discount code- If you have one
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Purchase Order Number (if applicable :)
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Total number of delegates - for each delegate please complete the Full name, Email address and job title sections
*
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Full Name of Delegate 1
*
Your answer
Delegate 1 Email address
*
Your answer
Delegate 1 Job Title
*
Your answer
Full Name of Delegate 2
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Delegate 2 Email address
Your answer
Delegate 2 Job Title
Your answer
Full Name of Delegate 3
Your answer
Delegate 3 Email address
Your answer
Delegate 3 Job Title
Your answer
Full Name of Delegate 4
Your answer
Delegate 4 Email address
Your answer
Delegate 4 Job Title
Your answer
Name of person completing form
*
Your answer
Date form completed
*
MM
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YYYY
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