NORMIT Course Application Form

Course Details Please select which Course you would like to attend
Your Details Title
First Name*
Last Name*
Telephone
Mobile
Email Address*
Job Title
Organisation*
Address
Any Special Requirements, see below	Vegetarian Accessibility Vegan Other (Please Specify)
NORMIT Member	Yes No
Voluntary or Charity Organisation	Yes .... No
Emergency Planning Society Member	Yes .... No
Business Continuity Institute Member	Yes .... No
Payment Details Please send invoice	Yes No
Purchase Order Number
Invoice address if different to above (include contact Name)
Cheque to follow by post	Yes No Please make cheque payable to Norfolk County Council and send to Emergency Planning Unit, County Hall, Martineau Lane, Norwich, NR1 2DH
Additional Comments Lunch and refreshments will be provided. If you have any special requirements or needs to enable you to participate fully in this event, please let us know: eg physical access, hearing loop or dietary requirement.

Special Requirements

Please Note:

1.	Joining instructions will be issued 1 month before the event date. Cancellations prior to this date will not be subject to a charge.
2.	No refund will be made if cancelled within 1 month of the event. If you are unable to attend the course, please try to find a replacement and notify this office on 01603 222016
3.	Your details will be held by the Emergency Planning Unit in accordance with the Data Protection Act and information may be sent to you regarding future courses.
4.	We reserve the right to cancel courses as necessary.