Your event
If you have signed up to take part in an event, or are planning your own, please let us know. We'd love to hear about it - knowing more about the event means we can work out how best to help you :)
What is the event you're taking part in/organising?
Please give a name to your event, and a brief description of what you're planning, eg coffee morning, Christmas ball, 10k run etc
Your answer
Date of your event
When is the event happening (or starting if it's a multi-day event)?
MM
/
DD
/
YYYY
Location of your event
Where is it happening - eg Haywards Heath Town Hall, or Land's End to John O'Groats
Your answer
Size of event you are organising
Please give an estimate of the number of people you'll be expecting at your event (this helps us ensure you get the right number of leaflets, posters, etc)
Your answer
Title
Mr, Ms, Mrs, Miss, Dr, etc
Your answer
Your First Name
Your answer
Your Last Name (surname)
Your answer
Street Address 1
The first line of your address, including house number/name
Your answer
Street Address 2
Your answer
City/ Town
Your answer
County
Your answer
Postcode
Your answer
Phone (preferred contact number)
Please give the number you'd prefer us to contact you on, eg home, or mobile
Your answer
Email
Your answer
Email is the most cost-effective way for us to keep in touch with you. If you are happy for us to contact you by email, please tick here.
If you are willing to share your story with the media and to raise awareness of group B Strep, the work of the charity, and your involvement with this event, please check the Yes option.
We promise NEVER to release your information to anyone else without your express permission. We would like to contact you in the future about Group B Strep Support’s activities. If you would rather NOT receive these communications, please select No Communication.
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