Name of Facilitator
Contact number of Facilitator
Email of Facilitator
Workshop Category	Please Specify............ Voluntary Organisation Regional Assembly Regional Development Agency Multi-agency group (other than LSP) Academic department Community Organisation Local Strategic Partnership (LSP) Primary Care Organisation District/Borough Council County Council/Metropolitan Borough Strategic Health Authority NHS Trusts Government Office Population Please Specify............ up to 80,000 80 - 500,000 500,000 - 2 million 2 - 9 million Unspecified
Date of Workshop(dd/mm/yy)
Number of participants in Workshop