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					    Cross-cultural surveys and research synthesis: an iresearch4birth training school

                  Monday February 27th and Tuesday February 28th, 2012
Venue: School of Nursing and Midwifery, Trinity College Dublin, 24, D’Olier St, Dublin 8, Ireland

                                             Registration form


Title: ___________________

First Name: _________________________________________

Surname:       ______________________________________________

Name of organisation (if any): ___________________________

Address for correspondence:______________________________

_______________________________________________________

Tel. No.       ____________________ E-mail:                    __________________

Dietary requirements:          ________________________________

Accessibility requirements (wheelchair access etc):                    _____________



I am (please tick one option only)

A subsidised                   A non-subsidised                        A non-COST
COST delegate                  COST delegate                           delegate


Registration fee
The fee covers the seminar/workshops, materials, refreshments and lunch. Please tick the box
beside the day/fee you are paying. N.B. Pay before 23rd Jan to get the Early Bird rate!

                                                        Early Bird          Tick         Fee          Tick
                                                        Fee (before
                                                        23rd Jan
                                                        2012)
Monday 27th February               Cross-cultural       € 45                             € 55
                                   surveys
Tuesday 28th February              Research             € 45                             € 55
                                   synthesis



 _____________________________________________________________________________________________________
 Jeni Ryan, Administrative Officer – Events | Tel + 353 (0)1 896 3860 | Fax: + 353 (0)1 896 3001 | ryanjen@tcd.ie
COST Training School:
Cross-cultural surveys and research synthesis: an iresearch4birth training school

____________________________________________________________________________

                             Methods of Payment for Conference Fees

Paper (cheques, postal orders and bank drafts)
Cheques, postal orders and bank drafts must be made payable to
Trinity College Dublin No. 1 Account.

The cheque / postal order / bank draft must be in Euro and drawn on a bank in the Republic of
Ireland. Cheques / postal orders / bank drafts received in any other currency or made out to any
other name will be returned for re-issue.


Bank transfer (EFT)
Payment may be made via this method. Please email Jeni Ryan (ryanjen@tcd.ie) for further
details. The delegate will be liable for any transaction fees incurred by this method of
payment.


Refunds
Requests for refunds must be made in writing or via email to Jeni Ryan (ryanjen@tcd.ie).
Registration fees may be refunded up to Monday 13th February 2012, less 10% administration
charge. No fees will be refunded after that date.


Substitutions
In the event that a delegate cannot attend, their registration may be transferred to an alternative
delegate. The change of name for the registered place should be notified to Jeni Ryan
(ryanjen@tcd.ie), giving as much notice as possible.


Receipts
Receipts will be issued for all payments received.




 _____________________________________________________________________________________________________
 Jeni Ryan, Administrative Officer – Events | Tel + 353 (0)1 896 3860 | Fax: + 353 (0)1 896 3001 | ryanjen@tcd.ie
COST Training School:
Cross-cultural surveys and research synthesis: an iresearch4birth training school
____________________________________________________________________________

Credit / Debit Card
Cards that are accepted are VISA, MASTERCARD or LASER. To pay by this method, please
complete the form below and return it by post or fax. DO NOT email credit / debit card details
as any personal information submitted is not encrypted and is not protected as it passes over
the network. The cardholder’s signature is required to complete the transaction.

 Card type          MASTERCARD                         VISA                       LASER

 Card No.


Expiry Date
        /
Month                  Year

 Cardholder’s Name


 Billing Address




I agree to the sum of €     being charged to my credit / debit card in respect of fees for
the COST Training School: Cross-cultural surveys and research synthesis:

 Cardholder’s Signature




Registration forms and payments should be returned to:

Jeni Ryan (ryanjen@tcd.ie)
Administrative Officer - Events
School of Nursing & Midwifery, Trinity College Dublin
24 D'Olier Street, Dublin 2, Ireland
Tel: + 353 1 896 3860
Fax: + 353 1 896 3001


 _____________________________________________________________________________________________________
 Jeni Ryan, Administrative Officer – Events | Tel + 353 (0)1 896 3860 | Fax: + 353 (0)1 896 3001 | ryanjen@tcd.ie

				
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