Sign up to Let’s Meet 2022

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 six sessions on offer. Please select which three you’d like to attend, as well as an alternative session in case your first choice isn’t available.

Please select your first session choice *

Please select your second session choice *

Please select your third session choice *

Please select a fourth backup session, in case the above sessions aren't available *

Your details

Salutation *

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 on the day.

Phone *

Email *

Area *

County *

How old are you? *

Ethnicity

Due to the nature of this event, please could you provide us with further information about your cervical cancer diagnosis? The information you share, will help us tailor the event to your needs.

Month of diagnosis

Year of diagnosis

Stage *

Treatment received *

We will be providing lunch on the day of the event. Please provide us with any dietary requirements

Do you have any additional needs, mobility requirements or anything else you want to let us know in advance so we can make sure we support you throughout the event?

Will you be bringing along your partner/friend/family member to the event? *

If yes, please provide us with their details:

Salutation

First name

Last name

Phone

Relationship

Dietary requirements

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)

Which of the previous events have you been to? Dates

How did you find out about this support event? *

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

We want to see cervical cancer become a disease of the past. With your help, we can make this a reality. We’d love to stay in touch with you to tell you about our latest campaigns, research and the ways that you can support our vital work. We’ll keep your details safe and we promise to never swap or sell them. If you change your mind and want to stop hearing from us or want to change the way you hear from us, please contact us on 020 3096 8100 or [email protected]. Please see our Privacy Policy for more information.

I am happy for you to contact me by:

Phone

Post

Text/SMS

I would like to hear about:

News and campaigns

Volunteering

Fundraising

Information for health care professionals