Student Strike Attendees Form

Please tell us if you are intending to take part in the physical student strike.

Name: Name: * First Last
Campus: *
Course: *
Year of Study: *
Your UCLan Email *
Your phone number: *

This is so we can contact you to make sure you are safe.
Name of Emergency Contact: *

This is so we can contact an appropriate person for you if there is an urgent situation.
Relationship to you:
Emergency Contact Number *
How will you be attending the physical strike?

For information on organised transportation, please visit the Strike Statement on the SU Website