Sign up to Let’s Meet 2021

Title

We hope to see you at our annual information and support event, designed just for you. Please complete the form below to sign up to the sessions you’d like to attend. If you have any questions about the event or sign up form, please email [email protected].

Sessions

This year we have eight sessions on offer. Please select which ones you’d like to attend. You can choose as many or as few sessions as you like.

All sessions will be an hour long, either at lunchtime or early evening.

Let’s Meet is a free event and you don’t have to make a donation to attend. If you feel able to make a donation, this will help us to continue to support women affected by cervical cancer, however this is completely optional.

Monday 13th September: Importance of Exercise, 1 – 2pm

Due to the nature of this session, the speaker has asked if you could provide us with further information, in order to tailor the session to your needs. The information you share, will only be shared with the speaker for the purpose of this session.

Please could you provide us with further information about your diagnosis e.g. stage and treatment received *

Tuesday 14th September: Let’s Talk, 5.30 – 6.30pm

Wednesday 15th September: Looking after your mental health, 12.30 – 1.30pm

Wednesday 15th September: Sex and relationships (with partners), 5.30 – 6.30pm

Will your partner also be joining the session?

If your partner is attending too, please can you provide us with their contact details. This information will only be used to obtain feedback after the session.

Title *

First name *

Last name *

Email *

Thursday 16th September: Yoga, 12.30 – 1.30pm (Women and people who have cervical cancer only session)

Please could you provide us with further information about your diagnosis and any other medical conditions, e.g. stage and treatment received *

Thursday 16th September: Sex and Relationships (new relationships), 5.30 – 6.30pm (Women and people who have had cervical cancer only session)

Friday 17th September: Let’s talk, 12.30 – 1.30pm

Friday 17th September: Mindfulness, 5.30 – 6.30pm

Your details

Title *

First name *

Last name *

Please provide us with the below contact details. We will be using the information you provide, to check in before the event and send you any information you may need to join us for each session.

Phone *

Email *

Area *

County *

How old are you? *

Ethnicity

When did you receive your cervical cancer diagnosis? (We are asking so we can best support you at the event)

Month of diagnosis

Year of diagnosis *

Will this be the first Jo's support event you have attended? *

Which of the previous events have you been to? (select all that apply)

Other events you've attended

How did you find out about this support event? *

Please specify here:

I agree my attendance, should I no longer be able to attend I will let you know. *

Donation

Your donation

Thank you for choosing to make a donation with your booking. Please enter your billing address and payment details below.

Donation amount

Street address (inc. door number/house name)

Postcode

Gift Aid

If you are a UK tax payer, you can boost your donation by 25p for every £1 you donate. Please tick the box below.

Gift aid

I confirm/reconfirm I am a UK taxpayer. Please treat all donations I make or have made to Jo's Cervical Cancer Trust for the last 4 years as Gift Aid until further notice. I understand that if I pay less Income Tax and / or Capital Gains Tax than the amount of Gift Aid donations claimed on all my donations in that tax year it is my responsibility to pay any difference. Please let us know if you wish to cancel this declaration, change your address or stop paying tax.

Payment

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