Promoted Jointly by Wakefield Support Group for Autism and Sure Start - Wakefield
Monday 14th. June 2004
Please book as soon as possible as this
event has limited places available.
Places will of course be allocated on a first come, first served basis.
Please tick category below as appropriate;-
Professional Delegates
Parent / Carers
£50.00 per delegate
£10.00 per delegate
Tick for professionals
Tick for Parents / Carers
1. ______________________________________ Position _____________________
2. ______________________________________ Position _____________________
3. ______________________________________ Position _____________________
4. ______________________________________ Position _____________________
Name of Organisation:_______________________________________
Tel. Nr. _____________________Email: __________________________________
Parent/Carer Delegates Full Name(s):____________________________________
Tel Nr. _____________________ Email: ____________________________________
I enclose a cheque for £ ________ made payable to Wakefield Support
Group for Autism.
Signed: _______________________________________Date: ______________
Return Address (For Both Categories) _______________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Please return your completed form and payment as soon as possible to;-
(please try to include a return address, stamped envelope, many thanks)
Catherine Milne
29 New Hall Close
Crigglestone
WAKEFIELD
WF4 3PH Tel;- 01924 255634