Event Attendance Request Form

All requests are submitted to the Public Health team for review. Complete the form below to request Public Health attendance at an event or to book a public health speaker. Ensure that all mandatory fields are completed and provide as much detail as possible. We require 28 days’ notice for event attendance. Requests submitted with less notice will be considered but cannot be guaranteed.

Please complete this form as accurately as possible

Forename

Surname

Email Address

Contact Number

Name of Organisation

Event Details

Name of Event

Date(s) of Event

Time(s) and time frame [include start time(s) and end time(s)]

Event description (no more than 100 words)

Aims and objectives of event (no more than 100 words)

Target audience

Estimate no. attending

Location of event

Staff liaison- contact on the day (name and contact details)

What type of support do you require?

When do you need to hear from us by?

Any other relevant details?

Thank you

Your completed form will be emailed directly to Public Health for consideration. We aim to reply to your request within 10 working days.