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Please complete the following form to confirm your attendance for the Regional Careers Expo.

Contact Name*
Organisation Name*
Address*
Phone*
Mobile
Email*
Website Address
Do you require a standard site?* (1x6ft table and 2xchairs)	Yes No
If NO, please outline your additional requirements
Please indicate if you require the following*	Table only Chairs only Tables and Chairs
Do you require power to your site?* (You will need to provide your own extension leads)	Yes No
If YES, briefly explain what it will be used for
Do you have any preference as to where your site is positioned (ie. situated near a certain industry or educational provider)
Number of people attending?*
Does any of your team have special dietary requirements?*	No Yes
If YES, please provide relevant details:
Please answer this simple question to confirm the authenticity of this form. What does 2 + 2 =:

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