Community Engagement Workshop Registration Form

First Name

Last Name

Email Address

Dietary Requirements

Please provide a brief statement explaining your lived experience in the areas of mental health and health inequalities

Please provide your address for payment purposes

Please confirm if you would prefer payment direct to bank/building society account or vouchers

Please note: If you choose payment direct to Bank/Building Society account, the account MUST be in your own name. Please bring your sort code and account number on the day of the event.

Would you like to be added to our mailing list for future opportunities to participate

If you are successful in securing a place on the workshop you will receive an invitation sent to the email address you provided.

Privacy notice

Please note:

The University of Warwick is the data controller of any information you have entered on this form and as such is committed to protecting your data and rights in line with applicable data protection law (including the UK GDPR and the Data Protection Act 2018). Please review the privacy information (including privacy notices) provided by the University via the following link, for further information on your rights and how the University processes your personal data: Data Protection.

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Warwick Medical School

Community Engagement Workshop Registration Form

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