Manchester Girl Geek Event Online Booking Form Details MANCHESTER GIRL GEEK DINNER #5 23rd February 2010 Location: Madlab Manchester, 36 Edge Street, Manchester. I wish to attend yes First Name * Last Name * Name of Company * Position in Company * Mobile Phone No. * Email Address * Dietary Requirements Vegetarian Other, please specify Disability Requirements Please do let us know if you require any assistance in terms of accessibility to this conference. Fields marked with * are compulsory