First name
Last name
Email
Mobile
1.
What is your organisation?
2.
What is the title of your proposed event?
3.
Please briefly describe the event (150 words or less)
4.
What is your preferred time slot?
Please select
Monday, 27 November, 11:30- 13:00
Monday, 27 November, 13:15-14:45
Monday, 27 November, 15:00- 16:30
Tuesday, 28 November, 11:30 - 13:00
Tuesday, 28 November, 13:15-14:45
Tuesday, 28 November, 15:00 - 16:30
Wednesday, 29 November, 11:30- 13:00
Wednesday, 29 November, 13:15-14:45
Wednesday, 29 November, 15:00- 16:30
Thursday, 30 November, 11:30- 13:00
Thursday, 30 November, 13:15-14:45
Thursday, 30 November, 15:00- 16:30
Friday, 1 December, 10:30 - 13:00
Friday, 1 December, 13:15-14:45
Friday, 1 December, 15:00 - 16:30
5.
Is your organisation an ICAN partner?
Please select
Yes
No