Event Attendance Request Form

All event requests are coordinated through the Healthy Sandwell Hub. If you would like to for Public Health to attend an event or to book a public health speaker please complete the form below providing as much detail as possible. We require 28 days notice to attend an event. Any requests submitted with less than 28 days’ notice will be considered, but we cannot guarantee attendance.

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.