If you wish for one of our Dyspraxia Foundation Youth Champions to appear, speak or come to your event and speak on behalf of the Dyspraxia Foundation, then please complete this form. If you have any questions please e-mail [email protected] Your Information Salutation * Mr.Mrs.MissDr.Ms.Prof.Rev.LadySirCapt.Other Forename * Surname * Email* Information about your Event Please indicate the Youth Champion(s) you require for your event: What is the location of your event (include Postcode): What is the purpose of your event? (Local Group Event / Conference / Awareness etc.): What subject(s) will our Youth Champions be speaking about? Please be aware that upon pressing submit your request will be sent to the Dyspraxia Foundation Youth Information Officer, who will reply to your request to gather more information. The submission of this form does not guarantee or confirm the attendance of a Youth Champion to your event.