Conferences > Conference Ambassadors > Forum Legati Membership Application Form

Forum Legati Membership Application Form

Please complete this form online.

Title:

First Name:

Surname:

Organisation:

Department:

Position:

Address:

Town / City:

Postcode

Country

Telephone:

Email:

How did you hear about forum legati?

I am a member of the following societies / associations

Association	Position
Association 1:	Association 1:
Association 2:	Association 2:
Association 3:	Association 3:

What are the most recent conferences you have attended?

Conference Title	Frequency	Date	Location
Conference 1:	Frequency 1:	Date 1:	Location 1:
Conference 2:	Frequency 2:	Date 2:	Location 2:
Conference 3:	Frequency 3:	Date 3:	Location 3:

Have you ever hosted a conference? Yes No

If yes, please give details:

Which association conference would you consider bringing to Merseyside?

Association conference #1:

Association conference #2:

Association conference #3:

Please tick this box if you agree
to allow this data to be held on file by
The Mersey Partnership Conference Bureau.
The Bureau agrees to hold any information for research purposes only and will not disclose
any information to any outside party.

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