Engage Academy 2024: Further Required Details Copied to clipboard We’re delighted to invite you to join us for Engage Academy 2024We need a few more details from you to help us with our planning for the 7 months course starting this coming January (2024). Please complete this form by Friday 1st December Data protection consentIn order to receive your application, the NCCPE requires your consent for us to process your personal data. Please see our Privacy Notice for information on how your personal data will be processed. Do you consent to the NCCPE processing your personal data for the following purposes? Questions Yes No Processing your application form for this role (consent is required for us to accept your application) Yes No Sending NCCPE emails to you about public engagement news and events Yes No Taking photographs/screenshots of me at Academy events Yes No Sharing my contact details with other academicians Yes No Your details First name Surname Name as you'd like it to appear on your delegate badge Please let us know if you'd like an alternative name on your badge to the one given above. Preferred Pronouns Email Telephone Online or In-Person Yes I will physically attend in person workshops No I will attend all workshops online In Person Access RequirementsWe are committed to ensuring that our workshops are as accessible as possible, all our venues are fully wheelchair accessible and have allocated accessible parking spaces if required. Please let us know about the requirements you have that will help you fully participate in the in person workshops in the section below. Please list any dietary requirements in the box below Online Workshop Accessibility We will be hosting online workshops and webinars on the platform Zoom. We will also be inviting you to join online peer learning groups and expert surgeries which are likely to use this platform. We would like to know of any requirements that would support you to access these sessions. Please tell us about any personal requirements you have and details of any adjustments you would like us to make to facilitate your participation in the online elements of the course. Peer Learning GroupWe will be convening learning groups of around 6. These will be three facilitated sessions (facilitated by academy graduates) lasting up to 90 minutes in which you you will be invited to think through your personal, professional and organisational development with the support of your peers. The sessions are an optional component of the course and will take place at a time agreed within your group. Please let us know if you would be interested in joining a peer learning group. Yes I would like to join a peer learning group No I would prefer not to join a peer learning group COVID-19 Considerations and Cancellation PolicyWe are committed to the health and wellbeing of event attendees, venue staff, NCCPE staff and the wider community, and therefore have put the following measures in place: If you are showing signs of and/ or have tested positive for Covid-19 please do not attend the in person workshopsHand sanitiser will be available at our venuesWe welcome the wearing of masks, and will provide them at the workshop venues. You are welcome to bring your own with youWe reserve the right to cancel the in-person element of the course if this is necessary to protect people's health. If such a decision is made, we will offer an online alternative and notify you as soon as we possibly can. If you have any further questions about the course please contact engage.academy@uwe.ac.uk Contract details Organisation name Organisation company number Name of contact who will be signing the contract Contact Role Email address of contact Are you planning to pay via the UWE online store (using a purchasing card) or via invoice? UWE online shop Invoice Please note: In order to pay via invoice, we will require a few more details regarding your finance team. Invoicing details Invoicing details Invoice address: please ensure this is your central finance department if applicable Finance contact name Finance contact email address Finance contact telephone Number Organisation VAT number (if applicable)
