Conference debit card payments

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Conference Booking 2009

Personal Details

Title Select an Item -------------- Mr Mrs Miss Ms Dr Professor Other

Other title

Surname

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Telephone

Fax

Job Title

Organisation

Please outline any access requirements you have

Member pricing

Member Pricing options Select an Item -------------- Three day registration (Ex VAT £295) (£339.25) Single day registration, Tuesday (EX VAT £150) (£172.50) Single day registration, Wedneday (Ex VAT £150) (£172.50) Single day registration, Thursday (EX VAT £120) (£138.00)

Non member pricing

non-member Pricing options Select an Item -------------- Three day registration (Ex VAT £345) (£396.75) Single day registration, Tuesday (Ex VAT £173) (£198.95) Single day registration, Wednesday (Ex VAT £173) (£198.95) Single day registration, Thursday (Ex VAT £150) (£172.50)

Social evening (free) Select an Item -------------- Yes No

Conference dinner

Would you like to attend the conference dinner? Select an Item -------------- Yes (£35 Ex VAT) (£40.25)

Dietary requirements (select if appropriate)

Vegetarian
Other (please provide below)

Other dietary requirements