Registration Form2012

							                                       CHPQA – EVENTS 2012
                      Venue: The International Space Innovation Centre (ISIC)
                 Electron Building, Fermi Avenue, Harwell, Oxfordshire, OX11 0QR


                PLEASE PRINT CLEARLY AND COMPLETE ONE FORM PER APPLICANT

      Name:…………………………………………………………………………………………...............
      Job title: …………………………………………………………………………………..…………….
      Company: …………………………………………………….………………………….……………..
      Address: …………………………………………………………………………………….…………..
      ………………………………………………………………………………………….………………...
      ………………………………………………………………………………………….…………….….
      Postcode ……………………………………………………………………………………..………...
      Email (for confirmation) ……………………………………………………………………………….
      Tel: …………………………………………….. Fax:………………………………………………….



Please tick in the relevant box below to indicate whether you would like to attend the workshop, seminar or both.

                                     Workshop                                Seminar
                                     09.30 – 12.45 hrs                       13.30 – 16.30 hrs

 Thursday 22 November 2012


 Thursday 29 November 2012


 Thursday 6 December 2012


Ample car parking is available at the venue and directions can be found here -
http://www.stfc.ac.uk/ISIC/About+ISIC/19546.aspx

Accommodation

If you wish to stay overnight you will need to make your own arrangements – some suggested local hotels are below:
   Milton Hill House - contact 01235 825716 or http://www.devere.co.uk/our-locations/milton-hill-house/contact-
     list.html
   Premier Inn - contact 0871 527 8868 or http://www.premierinn.com/pti/hotelInformation.do?hotelId=23872
   Steventon House Hotel - contact 01235 831223 or http://www.steventonhousehotel.co.uk/

          Please complete this form and return to the CHPQA Helpdesk without delay to ensure your place
                     Please send by email to chpqainfo@chpqa.com or fax to 0870 190 6334