BOOKING FORM Carbon Monoxide Awareness in Fuel Poor Homes Webinar 6 March 2024 (1:30pm – 4:00pm) TRAINING BOOKING (WEBINAR) – Carbon Monoxide Awareness in Fuel Poor Homes – 06 March 2025 (PM) THE CARBON MONOXIDE AWARENESS IN FUEL POOR HOMES WEBINAR IS AVAILABLE FREE OF CHARGE TO FRONTLINE WORKERS IN ENGLAND AND WALES THAT SUPPORT PEOPLE WITH HEALTH CONDITIONS OR DISABILITIES MADE WORSE BY LIVING IN A COLD HOME. TO BOOK A PLACE ON THIS WEBINAR, PLEASE COMPLETE THE FOLLOWING FIELDS THEN SUBMIT THE FORM. PLEASE NOTE: Once you complete the booking form and select submit you should see a confirmation note on screen. If not and instead you return back to the top of the booking form, your booking is not complete. Please check that all relevant fields are complete (all fields marked with a * are mandatory) and your e-mail address is correct then submit again. 1) LEARNER DETAILSFIRST NAME* SURNAME* JOB TITLE ORGANISATION* ORGANISATION SECTOR (Please select the most relevant sector or select other)*Advice agencyDistribution Network Operator / Gas Distribution NetworkEducationFuel UtilityGovernmentHealthHome Improvement AgencyHousing AssociationInstaller / ConstructionLocal AuthoritySmall Community GroupOtherN/AEMAIL* Enter Email Confirm Email TELEPHONE NUMBER*REGION (in which nation/ region is your organisation based – this should be your local office)*This information is required for monitoring the reach of learning across the country and reporting to funders. Personal details will not be shared with others.PLEASE SELECTEngland – North EastEngland – North WestEngland – Yorkshire & HumberEngland – London & South EastCOUNTY*This information is required for monitoring the reach of learning across the country and reporting to funders. Personal details will not be shared with others. POSTCODE*This information is required for monitoring the reach of learning across the country and reporting to funders. Personal details will not be shared with others. WHAT ARE THE MAIN SERVICES/ SUPPORT YOU PROVIDE TO PEOPLE WITH HEALTH CONDITIONS MADE WORSE BY LIVING IN A COLD HOME.*2) ELIGIBILITY FOR FUNDED PLACEAs indicated in the course outline, the Carbon Monoxide Awareness in Fuel Poor Homes webinar is available to frontline workers based in England and Wales that support people with health conditions or disabilities made worse by living in a cold home. To book a funded place, please complete the following questions to confirm that you meet the eligibility criteria for this course.Eligibility confirmation – job role* I confirm that I that support people with health conditions or disabilities made worse by living in a cold home. Eligibility confirmation – location* I confirm that I that work in England or Wales IMPORTANT NOTE: NEA relies on funding from external sources to enable us to offer free training activities. In order to fulfil our commitments to funders we need to ensure that learning takes place on time and that we meet the required minimum number of learners. Failure to do this may impact on future funding. If you receive a funded place and no longer wish to complete the course please inform NEA as soon as possible so that your place can be reallocated. 3) TERMS & CONDITIONS Once in receipt of this completed booking form, NEA shall contact the learner to confirm the place or offer an alternative if the session is already fully booked. Bookings are for the named person only, if you wish to change the attendee name please inform NEA in advance of the webinar date so that we can update our records on who will be attending (places are limited so anyone not officially booked may be turned away on the day). CANCELLATIONS: if you are unable to attend please inform NEA as soon as possible so that your place can be reallocated. Please note that while the place is free of charge to the learner there is a cost implication to NEA to deliver the webinar and failure to inform us that you are unable to attend prevents us from being able to re-allocate the place and can have knock on implications to future funding. Regular cancellations or non-attendance may result in future bookings being blocked. Notice of cancellation must be confirmed in in an email. AGREEMENT* I agree to the above terms and conditions of booking4) DATA PROTECTIONNational Energy Action collects personal information when you book on to a training event; this is used to provide the services requested; report to funders (if necessary); and to evaluate our services. We will not share your details with any other third parties without your consent. By submitting your booking form, you are agreeing to these terms. Our full privacy policy can be viewed at the following link – https://www.nea.org.uk/privacy-policy/ AGREEMENT* I agree to the above privacy policyMAILING LISTS*From time-to-time NEA may also send details of further projects / training events including free courses. Would you like to be included in these mailings? YES NO 5) CONFIRMATIONIf you have read and agreed to the above information please select the submit button below to complete your booking. PLEASE NOTE: Once you complete the booking form and select submit you should see a confirmation note on screen. If not and instead you return back to the top of the booking form, your booking is not complete. Please check that all relevant fields are complete (all fields marked with a * are mandatory) and your e-mail address is correct then submit again. Once submitted you should receive a confirmation e-mail.
