Telephone: 03333 447928 Email: reception@swanadvocacy.org.uk

Be Heard Registration Form

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Your Details

Name

First

Last

Telephone Number

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Emergency Contact Details

Name

First

Last

Relationship to Person

Contact Number

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Venue Accessibility Needs

How do you travel to the venue?

(would you need to use public transport, car, bicycle, taxi etc)

Is there anything you would need at the venue?

(Could be accessible toilet, hearing loop, parking near the venue)

Is there anything that would make it difficult for you to attend a venue?

(Would you need someone to accompany you?)

Virtual Accessibility Needs

Do you have technology to access virtual meetings?

(Laptop, phone, internet, etc)

We can offer you support to learn how to access online meetings or support at home during online meetings. If you are interested or require this please let us know below:

Activities and Resources Accessibility

Our workshops will involve reviewing documents, watching videos, listening to audio, having group discussions, listening to other people’s views, individuals contributing. Would you need any support with this?

(This could include having a support worker with you,having subtitles on videos, having audio description for videos, providing documents in easy read, proving interpreters, translating documents into other languages)

Please let us know of any other support you may need to help you participate