Dementia in Film, Media and Culture - Registration

Registration for Dementia in Film, Media and Culture event on 31 May 2024 (09:00-18:15).

Please use this form to book your place at the 'Dementia in Film, Media and Culture' event on 31 May 2024

On completion of the form you will be directed to a Paypal link to make payment for your ticket. Ticket price varies.

Delegate Name (first name and surname) *

Delegate Organisation *

Job Title *

Email *

confirm email *

Phone number* *

Car Registration (if parking on campus)

Dietary Requirements

Vegetarian
Vegan
Gluten-free
Dairy-free
Other (please state)

Other dietary requirements

Please tick to indicate you have read and understood our Conference & Events Privacy Statement. *

Any other requirements / information we should know

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