Talk Request Form

   
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If you don't like this form then feel free simply to ignore it all and send mailto:juggler@solipsys.co.uk to let me know why you didn't like it.

  •  REQUIRED!! Eight plus 5? (digits only)
  •  REQUIRED!! Your email address
  •  Your real name
  •  Organisation
  •  Place for the lecture
  •  Postcode (so I can download a map)
You must answer the
first questions,
else your email
will be discarded
as spam.

Please click as many buttons as you like - this should take no more than about one minute, otherwise you're thinking too hard. You can leave blank as many as you like.

Have you read my Talk Requirements?


Audience:
 14-16
 Student
 Adult
 Professional
 Retired
 Mixed
 Other
Time:
 Morning
 Afternoon
 Evening
 Weekday
 Weekend
 Anytime
 Other
When:
 Very soon
 In a few weeks
 In a few months

You can select a collection
of months (You may need to
hold down the control or
shift keys while you click)


You can add anything here you feel I've missed. Don't forget, you can always just send mailto:juggler@solipsys.co.uk



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