Registration Form

To register, please complete the following form and print out. At present we are unable to offer online registration.

Fax completed form to: +44 (0) 1295 253334

Mail to: Tracy Collier, EFFoST/EHEDG Conference Secretariat, 47 Red House Road, Bodicote, Banbury,
Oxon OX15 4AZ, UK

Please register me for the EFFoST / EHEDG Conference 2007

Delegate Details

Title (Prof., Dr, Mr, Ms): Family Name: First Name: Job Title: Organisation: Address: Post/Zip code: Country: Telephone: Fax: Email: Special access or
dietary requirements:

Please tick this box if you do wish your email address to be given out to delegates of this conference, in the knowledge that it may be used by them for future 3rd party mailings.

Presenters should provide their abstract reference number in order to ensure that their material is included in the final program and abstract book
Ref:

Please send me information on having a table-top exhibit or sponsoring the conference.

Registration Rate

Full Conference Delegate
€595 + VAT @ 21% = €719.95

EFFoST/EHEDG Member Delegate
€535 + VAT @ 21% = €647.35

Part Registration
€450 + VAT @ 21% = €544.50
Please indicate: Wednesday/Thursday or Thursday/Friday

Please book ____  tickets for the optional Conference Dinner @ €50 + VAT @ 21% = €60.50 per ticket

Please tick the following boxes if you wish to attend the workshops/courses. Places are limited on these courses and will be allocated on a first-come, first-served basis
NovelQ Workshop (Wednesday 14 November) places limited
EHEDG Short Course (Friday 16 November AM) FULLY BOOKED
GHI Workshop (Friday 16 November PM) FULLY BOOKED

Payment Details

Total payment required €:
Please charge my Visa/Amex/MasterCard (Delete as applicable)
Card No.: Expiry Date: Today's Date:
Name & Address of Cardholder if different from above:
Name: Address:

DECLARATION (Please note that unsigned forms cannot be accepted) I have read and agree to abide by the payment and cancellation terms, and I understand that this form confirms my conference booking. I accept that from now on charges will be imposed for cancelled registrations, and that up to the full registration fee will be payable if I am unable to attend the conference for any reason.

 

Signed:__________________________________________________________________

Date:__________/__________/__________

Data Protection Notice: The personal information that you provide on this form will be used by Elsevier Limited, [a company registered in England and Wales with company number 1982084, whose registered office is The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, UK, conferenceinfo@elsevier.com (delegates are reminded not to email credit card information in any circumstances)]  and it’s offices worldwide to process your registration and, with your permission, may be used by us and affiliated and non-affiliated third parties for marketing purposes. We respect your privacy and do not rent, sell or disclose your personal information to any non-affiliated third party without your consent.

By submitting this form, you will be indicating your consent to receiving marketing messages from us unless you have indicated an objection to receiving such messages by ticking the boxes below.

If you do not wish to receive special offers or promotions from us about related products and services please tick the relevant boxes below and mail or fax this form back to us, or contact us at conferenceinfo@elsevier.com:
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(Delegates are reminded not to email credit card information in any circumstances.)

If you do wish to receive special offers and promotions from carefully selected third party products and services that we feel may be of interest to you, please tick the appropriate boxes below:
Fax Email Tel Post