Please complete the following form to book a Talk for Change with Barry & Margaret.
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What's your name? *

 
What is the name of your school/organisation name?

 
Is there a specific reason that you want Barry & Margaret to share Jimmy's story?

If there's no specific reason, feel free to skip this question.
 
Where would you like the talk to take place? *

Please include the address and postcode.
 
When would you like Barry & Margaret to visit? *

If your preferred date isn't available, we'll get back to you with an alternative. If you don't yet know, feel free to put the first day of the month in whichever month you currently have in mind.
 
What time of day would you like them to talk? *


 
How old are the audience going to be?

If there is a mixed audience, please choose the youngest likely to be present.

 
What's the best telephone number to reach you on? *

 
We'd also like to find out more about who you are...

If you have a website, please let us know below:
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