Registration form [WP1563] In this section Registration form [WP1563] Event Registration - MASTER OLD 1Introduction2Personal information3Professional information4Data protection and privacy5Policy themes6Biography7Individual requirements8Travel information HiddenIntroductory paragraph{event_title} Please complete and submit your registration in order to book a place at this event. If you have any queries about registering please get in touch with {organiser} on {organiser_email} Personal InformationTitle (Ms, Mr, Mrs, Dr, etc) First name* Family name* Name shown on badge Citizenship* EthnicityWe are collecting data on the diversity of our participants. We want to ensure we maintain a clear and consistent focus on diversity and inclusion. Collecting this data will allow us to monitor this more effectively. This information will be treated confidentially and the data will be anonymised. Year of birth Gender* Woman Man Prefer not to say Other Provide more detail Professional InformationJob title* Organisation* Office address* Street Address Address Line 2 City Postcode Country* Email* Website If you are happy to be included in any social media campaigns we undertake for this event, please provide your Twitter handle Contact phone numbers*Please include country codes where appropriate. Use the + symbol to add further rows.Office / PrimaryMobileOther Assistant detailsPlease include country codes where appropriate. Use the + symbol to add further rows.NamePhone numberEmail address Would you prefer we liaise with your assistant? Yes, thank you Data Protection and privacyWe will only use your personal information as set out in our Privacy Notice or you can request a copy of it by contacting us directly. If you wish to make any requests relating to the manner in which Wilton Park uses your personal information, please contact our DataProtectionOfficer@wiltonpark.org.uk or the contact details set out in our Privacy Notice. We may want to invite you to Wilton Park events in the future. Please confirm if you would be happy to receive emails from us inviting you to our future events* Yes, I consent to Wilton Park sending me invitations to future events in my specialist field. No, I do not consent to Wilton Park sending me invitations to future events in my specialist field. By selecting ‘No’ you will not be invited to future events, including events like the one you are currently registering for. We may on occasion provide your name and contact details to Government Departments and public authorities in the UK. Please confirm if you consent to this information being shared.* Yes, I am happy for my details to be shared. No, I would prefer you didn’t share my details. All event participants will receive an address list after the event so that you can stay in touch with people you have met. We will give you the opportunity to amend your contact information for this address list during the event.Please confirm whether you agree to your contact information being shared with the participants at the event.* Yes, I am happy for my contact details to be shared. No, I would prefer you didn’t share my contact details. During the event we will take a group photo which will be shared to all people participating at our event. The purpose of the photo is to help you identify people you have met at the event and aid future networking.Please confirm that you agree to being identified in the event group photo.* Yes, I am happy to be identified in the group photograph. No, I do not want to be identified in the group photograph. Please tick up to four boxes to indicate which policy themes are relevant to your areas of work. Conflict prevention, resolution and state building Defence and security Global economy Multilateral institutions, key countries and regions Sustainable development and the environment Human rights, good governance and faith BiographyPlease provide a short biography (bio), no more than 200 words, for inclusion in our participant literature. If your bio is included it will not be edited and will appear as you have supplied it. Please do not provide us with a link as we are unable to process this.I would like to supply a biography at a later date Yes please If you don't have a biography prepared now do not worry, continue with the rest of the form and submit. Individual requirements{accessibility_information}If you have limited mobility or will have heavy luggage with you, please let us know with additional details in the field below.If you have any additional special requirements please give details:Please let us know of any other requirements, including medical needs (such as a fridge in your room for medication or a disposal box for syringes) Any special meal requirements can be supplied in the field further down this page.Special meal requirementsPlease give details of any dietary requirements or food allergies:For example: vegetarian, vegan, gluten free, kosher, halal, etc. Unless you request a special meal (such as vegetarian or halal) we can not guarantee we will be able to provide this for you. {travel_information}Your arrival{arrival_information}How will you be arriving?*Please select from one of the options below By train - The closest station is Shoreham-by-Sea. From there you can get a taxi. Estimated journey time: 20 minutes. Approximate cost: £25 {coach_arrival} By private car - We will need the registration of the vehicle Other arrangements – please give details Date of arrival DD slash MM slash YYYY Time of arrival : HH MM AM PM AM/PM Private car registration Please provide some more informationArrival flightsArrival airport Terminal Flight number Airport your outgoing flight departs from Flight arrival date DD slash MM slash YYYY Flight arrival time : HH MM AM PM AM/PM Your departure{departure_information}How will you be departing?*Please select from one of the options below By Train – our closest station is Shoreham-by-Sea. If you advise us of the train time we can organise a taxi for you. Cost is approx. £25, journey time approx. 20 mins. {coach_departure} {coach_departure_heathrow} By private car Other arrangements Flight departure date DD slash MM slash YYYY Flight departure time : HH MM AM PM AM/PM Date of departure DD slash MM slash YYYY Time of departure : HH MM AM PM AM/PM Please provide some more informationDeparture airport and terminal no. Flight number Destination HiddenCan we help with your departure? Transport to Gatwick Airport 1400 on Insert date only Arrives Gatwick Airport 1445 approx. Transport to Heathrow Airport 1400 on Insert date only. Arrives Heathrow Airport 1600 approx. Train from Shoreham-by-Sea. If you advise us on train time we can organise a taxi for you: Cost: £25 approx. Private car (please give registration) Other arrangements – please give details HiddenPrivate car registration HiddenPlease provide some more information Δ