Leadership Espresso: Expression of Interest Expressions of Interest Terms and Conditions* Yes No (Form will not be accepted) By completing and submitting this form: I hereby give SELA consent to keep a record of my name, job role, organisation, band (if applicable), telephone number and email address on their secure contacts database for management information and communication purposes. Please see our Privacy Notice. You can opt-out of these arrangements at any point by contacting us at [email protected] Contact DetailsFirst Name* Surname* Role / Job Title* Organisation*Ashford & St Peters Hospitals NHS Foundation TrustBerkshire Healthcare NHS Foundation TrustBerkshire West CCGBrighton & Hove CCGBrighton and Hove City CouncilBrighton and Sussex University Hospitals NHS TrustBuckinghamshire CCGBuckinghamshire Healthcare NHS Foundation TrustCentral Surrey HealthDartford and Gravesham NHS TrustEast Berkshire CCGEast Kent Hospitals University NHS Foundation TrustEast Sussex CCGEast Sussex County CouncilEast Sussex Healthcare NHS TrustFareham and Gosport CCGFirst Community Health and CareFrimley Park Health NHS Foundation TrustHampshire & Isle of Wight Partnership of CCGsHampshire Hospitals NHS Foundation TrustIndependentIntegrated care 24Isle of Wight CCGIsle of Wight NHS Foundation TrustKent & Medway NHS & Social Care Partnership TrustKent and Medway CCGKent Community Health NHS Foundation TrustKent County CouncilMaidstone & Tunbridge Wells NHS TrustMedway Community Healthcare CICMedway CouncilMedway NHS Foundation TrustNorth East Hampshire & Fareham CCGNorth Hampshire CCGOxford Health NHS Foundation TrustOxford University Hospitals NHS TrustOxfordshire CCGPortsmouth CCGPortsmouth Hospital NHS TrustQueen Victoria Hospital NHS Foundation TrustRoyal Berkshire NHS Foundation TrustRoyal Surrey County Hospital NHS Foundation TrustSolent NHS TrustSouth Central Ambulance Service NHS Foundation TrustSouth East Coast Ambulance Service NHS Foundation TrustSouth Eastern Hampshire CCGSouth, Central and West CSUSouthampton City CCGSouthern Health NHS Foundation TrustSurrey & Borders Partnership NHS Foundation TrustSurrey and Sussex Healthcare NHS TrustSurrey County CouncilSurrey Heartlands CCGSussex Community NHS Foundation TrustSussex Partnership NHS Foundation TrustUniversity Hospital Southampton NHS Foundation TrustWest Hampshire CCGWest Sussex CCGWest Sussex County CouncilWestern Sussex Hospitals NHS Foundation TrustOtherIf you selected 'Other' to the previous question, please specify. Please select the ICB your organisation is inBuckinghamshire, Oxfordshire and Berkshire West ICBFrimley Health and Care ICBHampshire and Isle of Wight ICBSurrey Heartlands Health and Care Partnership ICBSussex Health and Care Partnership ICBKent and Medway ICBI do not knowOtherIf you selected Other, please specify: E-mail Address* Contact Phone Number* Interest in offer or programmePlease specify below the title of the offer or programme you are interested attending*Please specify the reason you were unable to join the currently offered event or programmeAlready fullShort noticeUnsuitable date/timeOther development needsOffer/Programme not currently being run