Registration Form (* Required fields are marked with an asterisk)
This information will appear on your name badge :
* Title, First name, other initials :
* Last Name :
* Affiliation :
Contact information:
Postal address :
Post code/Zip code :
Country :
* E-mail :
Office telephone :
Fax :
* Professional status :
Please select
Faculty
Postdoctoral
Graduate student
Other
Registration fee :
The registration fee may be paid in Pounds Sterling (£), US Dollars ($) or Euros (E). The fee is £40 (or $72 or E48).
Date of arrival:
*
Please select
Friday 4
th
September
Saturday 5
th
September
Sunday 6
th
September
Monday 7
th
September
Tuesday 8
th
September
Date of departure:
*
Please select
Monday 7
th
September
Tuesday 8
th
September
Wednesday 9
th
September
Thursday 10
th
September
* Do you wish to give a poster?
Please select
No poster
Poster
Title of poster
:
* Are you an invited speaker?
Please select
Speaker
Delegate
Talk Abstract (Speakers only)
:
Special Dietary Requirements:
None
Vegetarian
Vegan
Gluten free
No dairy
No fish
No fruit
Other - please enter in Additional Comments below
* Accommodation :
St Edmunds College, en-suite facilities (£65, $117 or E78 per night)
St Edmunds College, semi-en-suite facilities (£55, $99 or E66 per night)
Not needed/Own arrangements
Banquet :
Queens' College, Monday 7
th
Sept
. Tickets are £45 (or $81 or E54) each.
Please select your preferred choice of meal below by typing the number of meals required in the appropriate boxes.
Meat and Fish :
Vegetarian :
Payment :
* Payment method :
Please select
Cheque
Credit card (in Pounds)
Debit card (in Pounds)
Cambridge funds
* Currency :
Please select
Pounds
Dollars
Euros
* Total payment (incl. College Accomodation):
Credit card information (enter by hand on a printed form) :
Card type :
Visa
Mastercard
Card no. :
Expiry date (mm/yy) :
/
Security Code :
Name on card :
Cardholders's full address (to which statement is sent :
Signature :
Additional comments :
Cancel submission and
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.