Associate

Name

Organisation

Position

Address

Phone

Email

Areas of Activity
Please state e.g. primary education, short breaks,
transition

I would like to be involved by

Receiving regular informationAttending workshopsAttending regular meetingsTraining/speaking/facilitating

Thank you for completing this form. Any information used to help
us contribute to the planning and provision of
services in Cheshire East will be anonymised to make sure that
individuals cannot be recognised. Your details will not
be shared with any other agency and will be processed in accordance
with the Data Protection act 1988. You can
have your details removed at any time by contacting the Secretary
at the address below.

We would like to contact you from time to time with information
about services, newsletters and involvement
opportunities. Please indicate if you would like to be on our email
or text lists.

Email
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