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The Splash Project Leaflet

Please click on The Splash Project logo below for a copy of The Splash Project leaflet.
Leaflet for The Splash Project

After The Storm - Registration Form

Registration Form for After The Storm - Dealing with the Devastation of Antenatal Diagnosis, Pregnancy Loss, and Perinatal Death. On Friday 23rd November 2012 at The Centenary Centre Camborne.

Please fill out the form below, and then you will be taken to a link to Paypal to pay for and complete the registration for the study day.

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* Required information.
Name * Please enter your name here.
Address * Your address for written correspondance purposes. Please include postcode.
Email Address * Please enter an email address through which we can contact you
Contact Number * Please enter a telephone number.
Dietry requirements Please fill in if you have any dietry requirements. e.g. vegetarian, vegan, dairy free, etc.
Reason for attending * Please enter why you are attending.
Work
Voluntary
Personal Interest
Please Specify - job title, voluntary organisation, etc. Please specify why you have chosen work, voluntary or personal interest above. For example your job title or the voluntary organisation you represent.
Rate you should pay * If you are a student or MSW then the study day is being offered at a reduced price. Please check the appropriate box. When you are refered to Paypal you will to also select the correct menu option.
Study Day (£30 + £1 admin fee)
Student or MSW Study Day (£25 + £1 admin fee)

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