EDEG_Registration by nuhman10

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									                 REGISTRATION and ACCOMMODATION FORM
                    42nd Annual Meeting of the European Diabetes
                           Epidemiology Group of the EASD

        Robinson College, Cambridge, UK - 31st March to 3rd April 2007
Please return registration form and all payment documentation clearly marked
EDEG2007 by post or email to:
EDEG2007 Secretariat
MRC Epidemiology Unit
Elsie Widdowson Laboratory
120 Fulbourn Road
Cambridge
UK
CB1 9NL
Tel: +44 (0)1223 741468                   Fax: +44 (0)1223 330316
E-mail: register-edeg2007@mrc-epid.cam.ac.uk

Please write clearly in BLOCK capitals

Title (Prof/Dr/Mr/Mrs/Ms/Miss):
(as you would like it to appear on your name badge)


First name :



Family name:



Institution/Organisation:


Postal Address:




City:                                                 Country:


Postal/zip code


Tel:                                                  Fax:


e-mail:                                                Please tick if you do not wish your email to be
                                                       included in Participants List.

VAT Registration Number GB232927463
1. Registration fees
Payments can be made in Euros or Sterling by bank transfer, cheque, internet banking or
invoice (Institutions/Organizations only).

Please note: Registration fees include 3 nights accommodation at Robinson College, all meals,
coffee breaks, Welcome Reception and Gala Dinner.

Early registration before 8th February 2007:
EDEG Member 400 EUROS or               £275.00
Non Member        550 EUROS or         £375.00

Late registration from 9th February to 28th February 2007.
EDEG Member 450 EUROS or £310.00
Non Member         600 EUROS or £410.00


2. Accommodation
Arrival: Saturday 31st March 2007             Departure: Tuesday 3rd April 2007
Rooms are booked only upon payment of the registration fee.
There is no guarantee that rooms will be available after 28th February 2007.
Please indicate room requirement:                      Single          Twin/shared
Name of accompanying person if applicable:
(shared twin room only available)



3. Special Requirements
Dietary:


Access:


4. Accompanying Person
Option 1:
Accompanying person fee: 135 Euros or £90.00
(3 nights bed & breakfast accommodation in shared twin room only)

Option 2:
Accompanying person fee: 295 EUROS or £200.00
(includes 3 nights bed & breakfast in shared twin room, Welcome Reception, social programme and Gala
Dinner)

Additional meals will be charged at: Per Lunch – 26 Euros or £18.00
                                       Per Dinner – 42 Euros or £28.00
                                       Gala Dinner – 51 Euros or £35.00

Please give details of these meal requirements at Section 5.


5. Meal requirements for accompanying person: (Please tick which meals you are
paying for as per rates above)

           Sat 31st March           Sun 1st April            Mon 2nd April

                                      Lunch                     Lunch

              Dinner                  Dinner                  Gala Dinner (included in option 2)




VAT Registration Number GB232927463
6. Payment Details:                           (use this part if paying in EUROS)

If you wish to pay in Euros please complete the following section.
(We are unable to accept credit card payments)

                                         Please fill the appropriate box to indicate amount paid.

Early - before 8th February 2007
EDEG Member 400 EUROS
Non Member         550 EUROS


Late – 9th Feb to 28th Feb 2007
EDEG Member 450 EUROS
Non Member         600 EUROS

Accompanying person fee
Option 1: 135 EUROS
Option 2: 295 EUROS

Additional Meal costs for guest
Per Lunch      26 Euros
Per Dinner     42 Euros
Gala Dinner    51 Euros

Payment by cheque
I enclose my cheque for

Payable to The Medical Research Council with your name on the back please.

Payment by bank transfer
Please send a copy of the request to our office for identification of payment.

I have arranged to transfer the sum of:                                into your bank account
accepting all charges.

Name:          The Medical Research Council
Address:       Lloyds TSB Bank PLC, Old Town Swindon Branch, 5 High Street,
               Swindon, Wiltshire. SN1 3EN
Sort Code:     30-98-41
Account:       86267533
IBAN:          GB51 LOYD 3098 4186 2675 33
BIC No:        LOYDGB21106
Swift No:      LOYDGB2L

Payment by invoice
This option may only be used where your Institution/Organisation has agreed to pay your
fees. Invoices will not be issued to individuals.

Please invoice my Institution/Organisation for the sum of

For the attention of …………………………………………………………..

Postal Address (please give accurate details)
……………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………….
Your purchase order/reference for finance department …………………………………….

Cancellations: in writing at least 2 weeks before conference will incur 10% administration charge.
Later cancellations will be liable for the full conference fee.
VAT Registration Number GB232927463
7. Payment Details:                           (use this part if paying in STERLING)

If you wish to pay in STERLING please complete the following section.
(We are unable to accept credit card payments)

                                         Please fill the appropriate box to indicate amount paid.

Early - before 8th February 2007
EDEG Member £275.00
Non Member         £375.00


Late - 9th Feb to 28th Feb 2007
EDEG Member £310.00
Non Member         £410.00


Accompanying person fee
Option 1: £90.00
Option 2: £200.00

Additional Meal costs for guest
Per Lunch      £18.00
Per Dinner     £28.00
Gala Dinner    £35.00

Payment by cheque
I enclose my cheque for

Payable to The Medical Research Council with your name on the back please.

Payment by bank transfer
Please send a copy of the request to our office for identification of payment.

I have arranged to transfer the sum of:                                into your bank account
accepting all charges.

Name:          The Medical Research Council
Address:       Lloyds TSB Bank PLC, Old Town Swindon Branch, 5 High Street,
               Swindon, Wiltshire. SN1 3EN
Sort Code:     30-98-41
Account:       04948352
IBAN:          GB46 LOYD 3098 4104 9483 52
BIC No:        LOYDGB21106

Payment by invoice
This option may only be used where your Institution/Organisation has agreed to pay your
fees. Invoices will not be issued to individuals.

Please invoice my Institution/Organisation for the sum of

For the attention of …………………………………………………………..

Postal Address (please give accurate details)
……………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………….
Your purchase order/reference for finance department ……………………………………..

Cancellations: in writing at least 2 weeks before conference will incur 10% administration charge.
Later cancellations will be liable for the full conference fee.
VAT Registration Number GB232927463

								
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