<p> Booking Form</p><p>Building the Right Support, Transforming Care Together National Conference </p><p>Section 1: Name (s): Job Role: Organisation/Groups Name: Address: ...... </p><p>...... </p><p>Postcode: ...... </p><p>Email Address:</p><p>Telephone Number:</p><p>Section 2: You will be able to attend two workshops during the conference please select in order of preference 3 choices.</p><p>1. Improving support and the involvement of Black, Asian and Minority Ethnic disabled children young people (0-25 years) with learning disabilities and/or autism, who display behavior that challenges, including those with a mental health condition</p><p>2. Crisis – what is it, when does it happen, why does it happen and how can we prevent it happening? </p><p>3. Transforming Care Partnerships improving involvement and participation of local disabled young people and families.</p><p>4. The Mental Health Capacity Act and decision making in education and care. </p><p>Choice 1: Choice 2: Choice 3: Section 3:</p><p>Do you have any dietary/access requirements? Please provide details</p><p>...... </p><p>...... □ Please indicate if you require a BSL interpreter □ Please indicate if you require an induction loop</p><p>Vegetarian food and a prayer room will be provided. </p><p>Section 4 Registration fees</p><p>Please tick the appropriate box and complete your details below.</p><p>(Subsidised places for parents/carers, disabled persons and small voluntary, community groups)</p><p>Statutory and large organisations □ £45 I am a parent/carer □ Free Small, voluntary, community groups □ Free</p><p>□ I enclose a cheque for £ made payable to Include Me TOO □ Please invoice me for £ at the address above/at the following address (delete as appropriate).</p><p>Invoice address: Name ...... </p><p>Address ...... </p><p>...... </p><p>Postcode ...... </p><p>To book a place please complete booking form by Wednesday 22nd March 2017 and email or post to: </p><p>Mina Patel, Include Me TOO, Newhampton Arts Centre, Dunkley Street, Wolverhampton, West Midlands WV2 4BH</p><p>Telephone 01902 711604 / 01902 399888 Email [email protected]</p><p>Thank You</p>