SUMMER CONFERENCE 2012 BOOKING FORM and INVOICE SfAM SUMMER CONFERENCE 2 — 5 July 2012 CLOSING DATE FOR REGISTRATIONS: Friday 22 June 2012. EARLY BIRD DISCOUNT of £50.00 is applied to all bookings made before 8 June 2012 Cancellation policy: Up to 30 days prior to the event all cancellations will be subject to a 10% cancellation fee, up to 14 days prior to the event there will be a 50% cancellation fee, and no refunds will be given on cancellations made within 7 days of the event. Full Member
FEES BEFORE 8 JUNE 2012
Student, Honorary, Associate & Retired Member
Student Non–Member
Non–Member
Full Conference Rate: (inc accommodation)
£250.00
£200.00
£400.00
£600.00
Conference Rate: (no accommodation)
£100.00
£50.00
£100.00
£200.00
Conference Day Rate:
£50.00
£25.00
£50.00
£100.00
FEES BETWEEN 9 JUNE and 22 JUNE 2012
Full Member
Student, Honorary, Associate & Retired Member
Student Non–Member
Non–Member
Full Conference Rate: (inc accommodation)
£300.00
£250.00
£450.00
£650.00
Conference Rate: (no accommodation)
£150.00
£100.00
£150.00
£250.00
Conference Day Rate:
£100.00
£75.00
£100.00
£150.00
Conference Day Rate delegates please tick the day you wish to attend:
Mon 2nd
Tue 3rd
Wed 4th
Thur 5th
INTELLECTUAL PROPERTY WORKSHOP: please tick this box if you would like to attend the workshop taking place on Monday 2 July 11.00 – 17.00 LEWIS B PERRY MEMORIAL LECTURE: please tick this box if you would like to attend the lecture on Monday 2 July QUIZ NIGHT: please tick this box if you would like to attend the quiz on Monday 2 July CONFERENCE DINNER: please tick this box if you would like to attend the dinner at The Hub on Wednesday 4 July (extra fee applies)
£50.00
*Non–Members please note: You can add 1 year’s membership to your event booking using this form, then register at the member rate and spend the same amount of money or less!
*ADD MEMBERSHIP TO YOUR BOOKING Add Student membership (£25.00):
Add Full membership (£50.00):
Y O U R D E TA I L S Title:
First Name:
Family Name:
Address: Postcode:
Tel No:
Email:
Special dietary or other requirements:
YOUR NAME BADGE Please enter the information below in BLOCK CAPITALS as you would like it to appear on your name badge First Name:
Family name:
Organization/Affiliation:
Y O U R PAY M E N T ● For all participants: The Society DOES NOT INVOICE for conference fees. Please treat your completed booking form as an invoice. Cheques must be in £ STERLING ONLY and made payable to ‘The Society for Applied Microbiology’. Foreign cheques/ drafts MUST be negotiable for the full amount due. We accept payment ONLY by the following credit and debit cards: VISA, Mastercard, Eurocard, Delta, Electron, JCB and Maestro. Cheque enclosed
Please charge my Mastercard/Visa card /Debit card (please delete inapplicable items)
TOTAL Amount enclosed/ to be charged: £ Card number: Issue No.
Expiry Date:
Start Date: (Debit cards only)
Security Code (last 3 digits on reverse of card):
Cardholder’s address to which credit card statement is sent:
Signature:
Date:
Please return the completed form by fax (post if you are enclosing a cheque) to: The Society for Applied Microbiology, Bedford Heights, Brickhill Drive, Bedford MK41 7PH, UK. Tel: +44(0)1933 382191. Fax: +44(0)1234 326678. Email: sally@sfam.org.uk
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