National Infertility Day

New Connaught Rooms, 61-65 Great Queen Street, London WC2B 6DA
Saturday 19th July 2008

Registration

To ensure that we account for all your requirements please complete all relevant parts of the form.

If you have any queries about your booking please contact our team on
Tel: 01323 637713 Fax: 01323 637777 Email: NID@confpeople.co.uk

Personal Details

* Title:

e.g. Mr/Mrs/Ms/Miss/Dr/Other

* First Name:

* Last Name:

Please complete if applicable:

Job Title:

Organisation:

Correspondence Details

This information will be used for all future correspondence relating to National Infertility Day.

* Address 1:

Address 2:

* Town/City:

County:

* Postcode:

* Country:

Contact Details

Please include all country and area codes.

* Tel no:

Mobile no:

Fax No:

* Email:

Delegate Fee

£15 per person - Patient

£35 per person - Those with a professional interest

Attendee Type

In order that you are registered correctly, please state if you are one of the following:

* Attendee Type:

* If other please specify:

Satellite Sessions

Sessions are allocated on a first come first served basis. Please indicate below your first, second and third choice of session. Wherever possible we will try to accommodate your first choice. To reduce any disruption to the sessions, we kindly request that you attend the full session and do not move from one room to another.

Morning Sessions (Time 10.45am)

* First Choice:

* Second Choice:

* Third Choice:

Afternoon Sessions (Time 1.30pm)

* First Choice:

* Second Choice:

* Third Choice:

Please send me details of the National Infertility Day BBQ:

Personal Requirements

Please indicate below any other personal requirements i.e. hearing loop, disabled access:

Donations

I wish to make a freewill donation to I N UK and ACeBabes.

Please add £

donation to my fee

I am a UK taxpayer and would like to Gift Aid my donation.

Gift Aid is tax relief on money donated to UK charities.

HM Revenue and Customs treat donations as if the donor had already deducted basic rate tax from them. The charity can then reclaim this tax to increase the value of a donation.

Where did you hear about National Infertility Day?

If other, please state:

Booking Terms and Conditions

No registration can be processed without full payment being received in £ sterling. Once payment is received a booking confirmation will be sent by email.

Cancellations must be made in writing to NID@confpeople.co.uk or by fax 01323 637777 by the latest Thursday 12 June 2008. If cancellation of your booking is received prior to Thursday 12 June 2008, a refund of your delegate fee will be made less an administration charge of £10.

By agreeing to the terms and conditions you confirm that you are liable to pay the above administration fee.

‘I confirm that I have read the registration terms and conditions and wish to continue with this booking.' *

Data Protection

By completing this booking you are consenting to your personal information being passed onto those parties involved in the administration of this conference.
If you do not wish to receive future correspondence from ‘I N UK and ‘ACeBabes’ regarding future events or developments please tick here

Please note: VAT is not applicable on delegate fees. I N UK and ACeBabes are registered charities. I N UK registered charity number 1099960. ACeBabes registered charity number 1082269.