Registration Form

Download the Registration Form in PDF format

YOUR DETAILS:

(Please complete in BLOCK LETTERS)
Title:
First Name:
Surname:
Tel No:
Email:
Fax:
Job title:
Organisation:
Address:
Postcode:
Country:

NAME BADGE DETAILS

(Please state how you would like your name badge to be displayed):
Name:
Organisation:

REGISTRATION FEES:

(please select appropriate fee)


METHOD OF PAYMENT

(please select as appropriate)

If you choose to pay by credit card, you will be redirected after submitting this form


If you are unable to pay via credit card please contact Beth Roberts (0151 706 4190, robertse@liv.ac.uk) or Joanne Isherwood (0151 706 5402, jish@liverpool.ac.uk)

CONFIRMATION OF BOOKING:

Confirmation will be forwarded by email or post.

CANCELLATION:

Cancellations received in writing, fax letter or email up to 30 days prior to the conference will receive a refund less 25% administration charge. Cancellations received after this date will be charged the full delegate registration fee.
Contact: office@eurolink-tours.co.uk

PLEASE TICK HERE IF YOU WISH YOUR CONTACT DETAILS TO BE EXCLUDED FROM THE DELEGATE LIST.

Arena and Convention Centre - Liverpool, Friday 19 March 2010

Translational Technology in Clinical Trials
European Scientific Meeting 2010