NI Assembly Explained Workshop Request Form - Page 1 of 4 - Northern Ireland Assembly

Introduction

1. What is your name?

Name (Required)

2. What is the name of your organisation/group?

Organisation name (Required)

3. How would you like us to contact you? Please provide an email address or telephone number below.

email / telephone (Required)

4. Are you the main contact on behalf of the group/organisation?

(Required) Yes No

5. If no please provide the main contact details below

Main Contact

6. What sector do you belong to?

(Required) Community/Voluntary Group Public Sector Organisation Business Other

Other (Please State)