<p> SOUTH EAST REGION </p><p>Thames Valley Network Workshop 2017 SPEAKERS & SPEAKING APPLICATION FORM Please use a separate form for each person</p><p>Name ……………………………………………………………………………………..</p><p>Email ……………………………………………………………………………………..</p><p>OR Postal address ……………………………………………………………………</p><p>…………………………………………………………… Post code:………………….</p><p>Telephone number ………………………………………………………………….....</p><p>The day, including lunch is free but MUST be booked in advance please. For catering purposes, please complete this section. I would like lunch. YES / NO (Please delete as appropriate) I have special dietry requirements: NO / YES (specify)………………….………</p><p>I certify that I belong to : (all applicants must be members of a U3A)</p><p>…………………………………………………………………………………………U3A</p><p>I am a Speaker Secretary YES / NO I am interested in improving my speaking skills YES / NO I am just interested YES / NO</p><p>Signed…………………………………………………… Date ………………………..</p><p>Please return completed forms to: [email protected] or Mrs Susie Berry OBE Lavender Cottage Telephone: 01844 281137 Box Tree Lane Postcombe Mobile: 07966 132738 OX9 7DY </p><p>Please enclose an s.a.e. for acknowledgement, if you have not given an email address.</p>