Application form - DWP Group Women 's seminar 09 - closing date for applications is noon 29.01.09

Application Form


DWP GROUP WOMEN’S MEMBERS SEMINAR 2009

23 February 2009
London
Date of course Venue

You should apply immediately to your line manager for special leave with pay.

Miss/ Mrs/ Ms (please delete as applicable)

Surname: .....................................................Forename: ...............................................................……….

Age: ....................Membership No: ..............................Group:(eg jc+) .............................................….

Address for mailing: .....................................................................................................................……….

.......................................................................................................................................................………..

Daytime telephone no: ............................................. Email: ……………………………………………..

Branch name: ..........................................................

Have you attended a Women’s seminar before: Yes 0 No 0

I would like to attend this seminar because:
......................................................................................…………………………………………………………
..................................................................................................................................................…………….
Are you a representative for PCS Yes 0 No 0

Special requirements (access, etc) ……………………………………………………………………………...
Conditions about which the organiser should be aware - eg disability (please specify):
……………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………...

Ethnic monitoring
The union is committed to the promotion of equal opportunities. To this end we are conducting a voluntary survey of all participants in our education programme.

Black African 0 Black Caribbean 0 Irish 0 UK/European 0 Asian 0

Chinese 0 Other 0 please specify: ..................................................


Signature of applicant: ........................................................ Date: …………………………….

Return to Yvonne Washbourne, Equality Officer, PCS, Ground Floor, 34 Lisbon Street, Leeds LS1 4LX. Tel: 0121 766 4396 or 0113 200 5300 or Fax to 0113 200 5301. By no later than 12 Noon Thursday 29 January 2009,