Time 4 Tea registration Host a Time 4 Tea event Please complete the form below Time 4 Tea 2017 registration Personal details TitlePlease select... Mr Mrs Ms Miss First Name Last Name Phone Whichever is your preferred number Email Company or Organisation (if appropriate) Date of birth (dd/mm/yyyy) How did you hear about this eventPlease select... Leaflet Facebook/Twitter Local press Search engine Meningitis Now website Email Previous participant Other Other - how I heard Your meningitis experiencePlease select... Personal experience Family experience Friend/Neighbour experience Nursery experience Pupil/Student experience Employee experience Professional experience No experience Address Street address Town County Postcode Event details When do you plan to hold your Time 4 Tea? Are you willing to share your story with the media and help us to raise awareness about meningitis, the work of Meningitis Now and your involvement?Please select... Yes No If you are happy to give us some brief details about your meningitis experience, please use this box Why are you interested in holding a Time 4 Tea?Please select... In memory In celebration Other Other - Please specify the reason How would like to receive your registration pack? Please select... Download PostTo help reduce our printing costs and enable us to spend more on our vital research and support, we’ve made all Time 4 Tea materials downloadable (you will be redirected there after completing this form) If you are holding this event in memory or in celebration, what is your relationship with the person? Select the way(s) you would like us to contact you We would like to contact you by post, phone, SMS and email to update you about our work and activities. If you are happy to receive this information from us, please tick the relevant boxes:I have selected how I would like to be contacted Post Phone SMS Email No contact By submitting you agree to the Terms and Conditions belowI agree Terms and conditions Need assistance with this form?