*All fields marked with an * must be filled in.
First name*:
Last name*:
Membership Number:
Job Title:
Organisation:
Address for Correspondence:
Line 1:*
Line 2:
County:*
Postcode:
Country:*
Email Address:*
Telephone No.
Daytime:*
Mobile:
Please fill in if this information is different to the one you have entered above e.g. Law firm service company etc.
If not please tick this box, to auto fill information from above
Organisation:*
Address:
1st Choice
2nd Choice
3rd Choice
No Room required
Single Occupancy
Double Room
Twin Room
Number of nights:
Price per night £
Total Cost £
(Price exc vat)
Tuesday 14th June 2011
Wednesday 15th June 2011
Thursday 16th June 2011
Friday 17th June 2011
Saturday 18th June 2011
Additional nights (specify night(s):
If you are booking a Double or Twin room for twin occupancy please advise the name of the additional person sharing, otherwise we will assume that the room is being booked for single occupancy and you will be charged accordingly. Note it is not possible for shared rooms to be arranged by the conference organisers.
Name of person sharing Double/Twin room is:
Please tick the boxes to confirm your requirements and the cost will be calculated for you.
Pre-Conference Seminar (£50/£45)
£
Conference Package (£435/£370)
Day Delegate
Wednesday 15th June, 2011 (£150/£130)
Thursday 16th June, 2011 (£150/£130)
Friday 17th June, 2011 (£150/£130)
Saturday 18th June, 2011 (£150/£130)
Dinners - (for Day Delegate bookings only)
Thursday 16th June, 2011 (£40)
Friday 17th June, 2011 (£55)
Subtotal
VAT
Total amount to be invoiced
Payment of Invoice by Bank Credit Transfers Payments submitted by Bank Credit Transfer will incur bank charges (please see Booking Conditions) which will be added to your invoice. Please tick the box to advise if your payment will be made by Bank Credit Transfer.
Please tick the boxes to confirm your attendance
14.00 – 15.00
1A
1B
1C
11.30 – 12.30
3A
3B
3C
15.30 – 16.30
2A
2B
2C
14.30 – 15.30
4A
4B
4C
16.00 – 17.00
5A
5B
5C
Please tick if you would be willing to act as a Chair of a session at the conference .
Name:*
Telephone*
Special requirements/requests (non-smoking/smoking, disabled, gluten-free, vegetarian, etc)
If applicable, please tick to advise if you are:
Please tick to advise if you require a Buddy
New Delegate
Overseas Delegate
Buddy Scheme
Please read Booking Conditions prior to completing this form. All completed forms should be sent to the Conference Organisers, Sovereign Conference. Bookings may also be made via our Website.
Please tick to confirm you have read and agree with the Booking Conditions.
