Booking Form - Development Site

LSP Booking Request Form

Section 1 - Your contact details - We will use this to contact you about any questions or clarifications needed to progress your booking. Full Name *

Email Address *

Telephone No. *

Section 2 - Invoice Contact details. If this is different to your details please ensure any personal details entered are done so with the consent of the Invoice Contact.

I have consent

Full name and address, including post code where we should send the invoice to

Email address of the person to be invoiced *

Telephone number(s) of the person to be invoiced *

Day and date of assignment (e.g. Monday, 19th June 2017) *

Assignment Start and Finish Times (Please indicate am or pm) *

Address of the assignment, include postcode *

Section 3 - Please note any information included in the following section could contain sensitive personal information. By entering information into this section (including deafness or other disabilities) you will need explicit consent to share this with us. Please tick the following box to confirm you have consent to do this.

I have consent

Name of attendees where possible. Please indicate all Deaf participants

Type of Language Service Professional required *

Number of Language Service Professionals required. (Further information in our Terms and Conditions). If you are unsure – please enter tbc and we will contact you to provide advice *

Details of the assignment e.g. name of event, topic of meeting, what is involved etc. Please do NOT enter any personal information in this section

Number of people attending *

Additional information helpful to the interpreter about the local area, parking, transport or directions

Is this an Access to Work booking? *

We would like to contact you in the future by email to update you on any news, events or offers that we think may be of interest to you. Please tick the following box if you consent to this.

Yes

I have read and agree to your terms and conditions *

Yes