Lecture – Stanford 100 – Professor Jeremy Dibble

Your Details

Title

First Name *

Surname *

Email *

Phone Number *

Do you have any accessibility requirements which will enable you to participate fully in the course?

Event Fee(s)

Event Fee *

Event Fee - £ 15.00

Total

If you are booking for more than one, you can do so using the drop-down at the top of this form. (Please include yourself in this number)

Booker's Declaration

• I am aged 18 or over | • On behalf of myself and the attendee(s) I am booking for, I accept the Terms and Conditions of Booking (click to open in new tab) | • If any of the attendees I am booking for are under 18, I confirm that I have parent/guardian permission

Booker's Declaration *

I have read and confirm the above declarations

If you are booking for more than one, you can do so using the drop-down at the top of this form. (Please include yourself in this number)