Training and Exercises Booking Form

This application form is only intended for the use by Staffordshire Resilience Forum members. However other Resilience Forum members may apply directly to the Staffordshire Civil Contingencies Unit (CCU) on 01785898618 where applications will be considered on merit. Attendance to events is not open to the general public.

In order to attend a training course or exercise please complete the following application form.

Once completed your details will be automatically sent to the CCU. This will not automatically reserve a place for you on the event until your application has been confirmed by return of email following which you will receive joining instructions.

If the event is over subscribed, the CCU will allocate places in the most appropriate manner.

It is important that all details are correct, as these details will be used on all the event documentation.

Thank you for using the CCU to book your training course or exercise event. This information will be held by CCU for the purpose of this event and will comply with the Data Protection Act 1998.

Names shown in bold are compulsory fields on the form.

Delegate DetailsTitle:

First name:

Last name:

Organisation:

Job Title Inc Rank:

Business address

Address 1:

Address 2:

Address 3:

Town:

Postcode:

Phone No (work):

Phone No (mobile):

Email address:

Additional Information

Preferred name on certificate of attendance:

Course Selection:

Do you have any particular requirements which may assist you in completing this event? E.g. accessibility, sensory assistance, special dietary requirements.:

Confirmation check

Please confirm that all details are correct prior to submitting completed form:

External links

Members

Staffordshire Civil Contingencies Unit

Stafford Fire Station
Beaconside
Stafford
ST18 0DD

Tel: 01785 898618
Email: ccu@staffordshirefire.gov.uk|