Yes please, we would like to take part in the
Health Related Behaviour Questionnaire in March 2018
School:	__________________________________________________________
Name of key contact: ___________________________________________________
Email address for key contact: ___________________________________________
EITHER
We would be delighted to participate using the online surveys	☐
OR
We would find online surveys difficult and would like to opt for paper versions instead. 
We understand that this will have a cost implication for the school. 
We also commit to:
•	administering the surveys within the same agreed 3 week window;
•	returning the surveys to Exeter by courier before the start of the Easter holiday.

If opting for paper versions, it is essential that you respond as soon as possible providing details of precise numbers of pupils in the appropriate year groups for your school so that your surveys can be prepared for you. Thank you.		
Year 2		
Year 4		
Year 6		
Year 8		
Year 10		

Please indicate below which briefing you would like to attend. Briefings are to be held on Tuesday 6th February 2018.

(Venue: Sans Souci Training Centre, Tanworth Lane, Shirley, B90 4DD)

Briefing	Tick or bullet point	Name of person attending (1 delegate only please)	
Briefing A:  1.00pm
	☐		
Briefing B:  2.30pm
	☐		
Briefing C:  4.00pm
	☐