Delegate Booking Form2011 by 1XjCa6C

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									                                          BAHVS - ‘ANIMAL ENERGY 12’
                          1-3 July 2011                  -      Moorside Grange Hotel, Disley Nr. Stockport


                                         DELEGATE REGISTRATION FORM
A.         Delegate Details:
Title:                         Name:                                                               Surname:

Address:




Tel. No:                                                                                 Fax No:

Email:


B.         Conference Fees (a range of packages and extras are available as detailed below) :
Item                                                                                          Members         Student/    Non-     Total (£)
                                                                                                               Retired   Members

A. Full Attendance (residential)
(Arrive Friday, depart Sunday – includes dinner, bed and breakfast, coffee, lunch and tea     £410.00         £310.00    £470.00
each day)

B. Two-Day Attendance (residential)
(Arrive Friday, depart Saturday OR arrive Saturday, depart Sunday) – includes one night
dinner, bed and breakfast, coffee, lunch and tea for two days)                                £270.00         £220.00    £320.00
Please state day of arrival: …………………….

C. One-Day Attendance (residential)
(Arrive Friday, depart Saturday OR arrive Saturday, depart Sunday – includes dinner, bed
and breakfast, coffee, lunch and tea)                                                         £190.00         £170.00    £220.00
Please state day of arrival: …………………….

D. Full Attendance (non-residential)                                                          £270.00         £210.00    £340.00
(Arrive Friday, depart Sunday 21 June – includes coffee, lunch and tea each day)

E. Two-Day Attendance (non-Residential)
(Arrive Friday, depart Saturday OR arrive Saturday, depart Sunday – includes coffee,
lunch and tea for two days)                                                                   £200.00         £150.00    £250.00
Please state day of arrival: …………………………………………

F. One-Day Attendance (non-Residential)
(Arrive and depart either Friday, Saturday OR Sunday – includes coffee, lunch and tea)
                                                                                              £120.00         £90.00     £150.00
Please state day of arrival: …………………………………………

Friday 1 July – Barbecue at the Hotel
Charge applicable to accompanying guests and those not resident at the Moorside               £25.00          £25.00     £25.00
Grange Hotel. For residents, this is included in the package.

Saturday 2 July – Conference Dinner
Charge applicable to accompanying guests and those not resident at the Moorside               £25.00          £25.00     £25.00
Grange Hotel. For residents, this is included in the package.

Extra room occupancy (accompanying guests)                                                    £25.00          £25.00     £25.00
Charge is per person per night and includes breakfast.

Extra nights accommodation
Charge is per person per night and includes breakfast.                                        £65.00          £65.00     £65.00
Thursday: ………………………                 Sunday: …………………..             (please tick)


                                                                                                     Total Fee Payable
C.         Special Requirements:
Please specify any special requirements:
(e.g. dietary, disability aids, etc.)


D.         Payment:
Cheques must be crossed and payable to the ‘BAHVS’. Payment must be made in full prior to the event. Cheques should be
forwarded with the completed booking form, or an invoice requested for the full amount payable and sent with your
purchase order (if applicable).

TOTAL DUE (Section B – Conference Fee):                                                                              £
If booking (with full payment) prior to 31 April 2011, you may deduct
£40.00 from the total. Please tick box to claim discount.

TOTAL PAYMENT DUE                                                                                                    £

Payment by cheque is enclosed                                                Please supply an invoice to the address below

Invoice Address (if different from
correspondence address overleaf):


Purchase Order No. (if applicable):


I will pay by BACS transfer to the BAHVS account.

         BAHVS Account Information: Bank: Lloyds TSB, Milngavie Branch, PO Box 1000, BX1 1LT.            Account Number: 76455360.       Sort Code: 87
         37 35.    IBAN: GB87TSBS87373576455360.        BIC: TSBSGB21240


I wish to pay by creditcard. My card details are provided below.

Creditcard (e.g. Mastercard/Visa/Switch):                                                Name of Cardholder:

Creditcard Number:                                                                                                Expiry Date:

Switch Issue No:                                                        Security Code (last 3 digits on reverse of card):

Address (to which creditcard statements sent):


E.         Notes:
           This event is valid for CPD certification for the Faculty of Homeopathy membership requirements.
•           A student denotes a veterinary undergraduate, not a student of homeopathy.
•           Delegates are welcome to bring partners and families to the event if desired. Accompanying guests are welcome to make full use
            of the university facilities during their stay. Prices for additional rooms with breakfast is shown on the booking form.
•           Any electrical equipment used on the premises must meet Health and Safety regulations (including laptops). Please ensure that
            any equipment you bring complies with UK regulations. Submission of your booking form confirms your agreement to abide by this condition.
•           Please ensure that you read and understand the Conditions of Booking as stated in the programme.


F.         BAHVS Membership:
             If you wish to become a member of the BAHVS, please tick the box and information will be sent to you.


G.         Booking form return/Enquiries to:
                                Altura UK Ltd, 8 Yew Tree Mews, York YO10 3PQ
               Email: gill@altura-events.fsnet.co.uk, Tel: 01904 898069, Fax: 01904 898715

								
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