Delegate registration 2012

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					                                   British Society of Audiology
      3rd Annual Conference and Experimental and Clinical Short
                           Papers Meeting
                                   Nottingham Trent University
                             Wednesday 5th to Friday 7th September 2012
                                   DELEGATE REGISTRATION FORM
                                 Registration Deadline - Friday August 24th

FULL CONFERENCE REGISTRATION:
(5th - 7th September including lunch and all refreshments, conference book including all abstracts
and delegate pack)
                                                  Registration before     Registration after
                                                   10th August 2012       10th August 2012

BSA members                                                          £89                            £99
BSA student members                                                  £79                            £89
All non-members*                                                     £99                           £109

ONE-DAY REGISTRATION:
(single tariff for any single day including
lunch and all refreshments, conference book                          £50                            £50
including all abstracts and delegate pack)
*Non-members are entitled to free membership for the remainder of the financial year. Details will be sent with
confirmation pack.
WINE RECEPTION                                   Wednesday 5th September                   £10
CONFERENCE DINNER                                 Thursday 6th September                  £27.50

ONE REGISTRATION FORM PER DELEGATE PLEASE

Prof/Dr/Mr/Mrs/Miss/Ms LAST NAME: ________________ FIRST NAME: ____________________
JOB TITLE: ____________________________________________________________________
PROFESSION: __________________________________________________________________
PLACE OF WORK: _______________________________________________________________
ADDRESS FOR CORRESPONDENCE: _________________________________________________
______________________________________________________________________________
______________________________________________________________________________
TELEPHONE: ____________________________________________________________________
E-MAIL: _______________________________________________________________________
BSA MEMBERSHIP NUMBER: _______________________________________________________

Registration forms should be accompanied by payment by cheque made payable to the ‘British Society of
Audiology’ or appropriate invoice details and an official purchase order number.

FULL CONTACT DETAILS FOR INVOICE: ______________________________________________
______________________________________________________________________________
______________________________________________________________________________
PURCHASE ORDER NUMBER: _______________________________________________________
YOUR BOOKING DETAILS

FULL CONFERENCE REGISTRATION:                                   COST £

BSA member                       £89/£99*                       ________
                                           *
BSA student member               £79/£89                        ________
                                               *
Any non-member                   £99/£109                       ________
*Delete as appropriate



ONE-DAY REGISTRATION (single tariff):

Wednesday 5th September £50                                     ________
                th
Thursday 6           September   £50                            ________
           th
Friday 7        September        £50                            ________

WINE RECEPTION FOLLOWING TWILIGHT LECTURE

Wednesday 5th September £10                                     ________

CONFERENCE DINNER

Thursday 6th September           £27.50                         ________


TOTAL COST                                                   £ ________
All prices are inclusive of VAT

Signature: _________________________________

Date: ______________________________________

Registration forms cannot be accepted unless signed.

CHECKLIST (please circle as appropriate)

Full payment enclosed                                            YES / NO / NOT APPLICABLE
Purchase order details enclosed                                  YES / NO / NOT APPLICABLE
BSA membership number provided                                   YES / NO / NOT APPLICABLE
Special dietary requirements       __________________________________________________
I require a Certificate of Attendance for CPD                                       YES / NO
I require use of a hearing loop system                                              YES / NO
I have read and agree with the BSA terms and conditions                             YES / NO




Please post a hard copy of this delegate registration form (both pages) to Mrs Catherine Ward at
The British Society of Audiology, 80 Brighton Road, Reading, RG6 1PS.
Confirmation and further details will be sent in due course
                                         IMPORTANT NOTICE

                            BSA Meeting and Conference Registration

                                        Terms and Conditions


Anyone wishing to attend a Society meeting or conference must first complete a registration form in
respect of that meeting and have received written confirmation of their registration from the
Society’s Secretariat prior to attending. If intent to attend a meeting is given by telephone or other
means, this must be followed by a completed registration form.

The registration form should be accompanied by payment in full. Delegates who expect a Health
Authority, Trust or other employer or organisation to pay must arrange for that organisation’s
cheque (or official Order Number and invoice address) to accompany the registration form. Where
that is not possible for any reason, the delegate must submit a personal cheque and seek
subsequent re-imbursement from the employer. Cheques will be retained by the Secretariat and
only banked ONE MONTH PRIOR to the meeting. Provisional bookings CANNOT be accepted.

Confirmation will normally be sent to delegates upon receipt of the registration form. If confirmation
is not received at this time, it is the responsibility of the delegate to obtain confirmation. A receipted
invoice will be sent out prior to the meeting.

In order to assist meeting organisers, delegates are requested to register as early as possible. Late
registrations will normally be accepted if space is available, but may be subject to an additional
charge.

If a delegate is unable to attend a meeting, a refund may be granted at the discretion of the
Society’s Trustees. The amount of any refund will depend upon the unrecoverable expenses incurred
by the Society. These will vary depending on the venue and, usually, on the amount of notice of
cancellation given to the Society by the delegate. Requests for refunds, stating the reason why the
delegate is/was unable to attend, must be sent to the Secretariat in writing within seven days of the
meeting. The Trustees’ decision shall be final.

Where meetings are subject to CPD points, Certificates of Attendance will be issued at the end of the
meeting.

These revised Terms and Conditions supersede all previous Terms and Conditions.


Although care has been taken in preparing course content, the British Society of
Audiology does not and cannot guarantee its interpretation and/or application. The BSA
cannot be held responsible for any errors or omissions and accepts no liability whatsoever
for any loss or damage howsoever arising. Opinions expressed are those of the
speaker(s) and do not necessarily represent the views of the BSA.

				
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