Your event If you have signed up to take part in event let us know. We would love to hear about your event and support you Your Event Personal details TitlePlease select... Mr Mrs Ms Miss First Name Last Name Phone Whichever is your preferred number Email 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 Which event are you taking part in? Date of your event? Location of your event? 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 taking part in this event?Please select... In memory In celebration Other Other - Please specify the reason 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 Need assistance with this form?