Booking form mr speaker eventfsm

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Question Time With The Speaker of the House of Commons and guests 12.15pm to 2pm Friday 26 July 2013 At Leeds Civic Hall Booking Form Closing date 5pm Friday 12 July This event is for people with a learning disability in the north of England. Up to 4 places per booking. We will tell you if you can come.

Name: Organisation (if any): Email: Telephone

Mobile

Address:

How many places for people with a learning disability How many places for supporting staff/carers If you would like more than 4 places, how many more? We will help if we can.

Will you or someone in your group be using a wheelchair? If yes. This person would like a seat

or to stay in their wheelchair

Please tell us if you have any other needs on the day:

Please email your completed form by 5pm on Friday 12 July to: Maggie.graham@mencap.org.uk Or post it in a stamped, addressed envelope to: Through the Maze, Mencap, Alexandra House, 2 Well Lane, Chapel Allerton, Leeds LS7 4PQ. Or phone 01706 215 074.


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