Science and Christian Faith in 2012 - An Enduring Partnership

A Christians in Science Conference

Friday 13th to Monday 16th July, 2012

at Queens’ College, Cambridge CB3 9ET, UK

Delegate Registration Form

Title / First Name
Surname / Position
Organisation
Address
Tel / Fax
E-mail
We prefer to correspond with you by e-mail. If you do not have an e-mail address, please indicate how you wish to receive communications.
Do you have any special dietary or disability needs we should be aware of? / Yes/No
If yes, please specify
Optional Extras Please indicate
Would you like to be kept informed about optional tours planned for the afternoon of Friday 13th July for those who arrive early (details and costs to be confirmed)? / Yes/No
Are you planning to submit an abstract for a poster or short talk (deadline is 31st May)? / Yes/No
If you are you registering accompanying persons who will not
attend the conference, please provide their full name(s).
We regret that children under the age of 16 are not permitted to stay at Queens’ College.
Travel and Membership Time or am/pm/eve Date
My arrival time and date
My departure time and date
I am a current member of: Please indicate
CiS / ASA / CSCA / ISCAST / VI / Other
·  Members of other affiliated groups should contact before registering.
·  If you wish to apply for CiS membership and claim the reduced registration fee, please do so before registering by visiting www.cis.org.uk/join.

/ … continued overleaf

Christians in Science Ltd, incorporated in England and Wales. Registered address 4 Sackville Close, Sevenoaks, TN13 3QD. Company No. 05959444. Registered Charity No. 1121422

Registration Fees (please refer to page 3 for what’s included)
Payments received up to 31st March 2012 / Whole event /

X

/

Per day

/

No. of days

Member* / 01 £90 / 02 £35
Non-member / 03 £180 / 04 £70
Full-time undergraduate / 05 £30 / 06 £10
Full-time postgraduate / 07 £50 / 08 £20
Accompanying persons (not attending conference) / 09 £25 / 10 £10
Payments received from 1st April 2012 / Whole event / X / Per day / No of days
Member* / 11 £130 / 12 £50
Non-member / 13 £260 / 14 £100
Full-time undergraduate / 15 £40 / 16 £15
Full-time postgraduate / 17 £80 / 18 £30
Accompanying person (not attending conference) / 19 £25 / 20 £10
* See Membership Information on Page 1 for qualifying organisations
Conference Fees (per day per person) / Dele-gate / No. of nights / Accom-
panying
person / No. of nights
Twin room (en suite) - based on 2 people sharing ** / 21 £131 / 22 £68
Single (en suite) / 23 £141 / 24 £78
Single (shared bathroom) / 25 £116 / 26 £53
Non-residential (charged to all non-resident delegates) – indicate number of nights / 27 £40
** Please complete a separate registration form for each delegate and tell the Secretariat who will share with you. ( Accompanying persons will not attend the conference, and should not complete separate forms.)
Dinners (non-residents and accompanying persons only) Please indicate X
Informal dinner on Friday, 13th July (optional) / 28 £18
Gala dinner on Saturday, 14th July (optional) / 29 £35
Barbecue on Sunday, 15th July (optional) / 30 £18
Total Payments Due
Total for registration fees mandatory / £
Total for conference fees mandatory / £
Total for dinners / £
Donation*** / £
Total payment due (see Cancellation Policy below) / £
*** Donations would be appreciated and will be used preferentially to subsidise attendance by
early-career scientists If you are a UK tax-payer and wish this donation to be treated as Gift Aid, please indicate here … and check that your full name, residential address, and postcode are provided on page 1.
Payment Options please indicate
a) I enclose a cheque made payable to Maggi Churchouse Events / £
b) Please send an invoice for payment by bank
transfer – name for invoice is:
c) I will pay online (www.maggichurchouseevents.co.uk/CiS)
Receipts will be provided for payment Options a and c above
Please return completed form to the Secretariat

Maggi Churchouse (Mrs), Conference Secretariat

Maggi Churchouse Events, 3 East Barn, Market Weston Road, Thelnetham, Diss IP22 1JJ, UK

Telephone and fax: +44 (0)1359 221004

Cancellation Policy

Cancellation or alteration received in writing by the Secretariat:

by 31st May will receive a 50% refund of nett fees paid

from 1st-30th June will receive 25% refund of nett fees paid

from 1st July will receive no refund of nett fees paid.

What’s Included

Fee type / Included items
Registration fee - Delegates / Attendance at all the conference sessions, delegate handouts and other CiS administration costs
Registration fee - Accompanying persons / CiS administration costs
Conference fee - Residential delegates / Bed and breakfast, lunch, dinner, and refreshment breaks, and other college fees
Residential accompanying persons / Bed and breakfast only
Other meals and refreshments not included
Conference fee - Non-residential delegates / Refreshment breaks, lunch, and other college fees
Evening meals are not included

Bursaries

We are actively seeking to encourage early-career scientists to attend. If you feel that you cannot afford the full conference costs, we hope to offer a limited number of bursaries. Please contact for information.

Accommodation inside and outside Queens’ College

Please note that room check-in time at Queens’ is from 2.00 pm and check-out time is by 9.30 am. There is a luggage storage facility available for your use at Queens’ at either end of your stay. Conference registration will open at 11.00 am on Friday, 13th July.

For information on accommodation outside Queens’ College, please refer to the Cambridge tourism website www.visitcambridge.org. We regret that children under the age of 16 are not permitted to stay at Queens’.

If you wish to arrange accommodation at Queens’ for dates outside the conference dates, please do so direct with the College - contact Kelly Anderson, .

Christians in Science Ltd, incorporated in England and Wales. Registered address 4 Sackville Close, Sevenoaks, TN13 3QD. Company No. 05959444. Registered Charity No. 1121422