Maudsley Prescribing Guidelines Conference – Registration Form

Tuesday 9th September 2014, B5 Auditorium, King’s College London (Waterloo Campus)

Your details (please complete a new form for each delegate)
ALL PAYMENTS TO BE RECEIVED with registration form by MONDAY 18TH AUGUST 2014
(Registrationprocess via KCL E-storewill substitute the booking form)
Registrants who wish to attend the conference after the closing date should contact the Event Organiser. This will be subject to the discretion of the Event Organiser and Event Chair.
More information can be found on our website:
Prof / Dr / Mr / Mrs / Ms / Other (Please circle)
First name
Surname
Job Title
Department
Organisation
Address
Post Code
Telephone / Work / Mobile
Email (preferred address)
Please write your address clearly as an e-ticket will be sent by e-mail as confirmation of place
Please also ensure you complete your full postal address details for our records
Please specify any special dietary or access requirements
This form must be signed by the delegate or an authorised person before we can accept the booking

Please confirm you have read and accept our terms and conditions:
Name
Signature(electronic signatures are accepted)
Date
Venue
B5 Auditorium
Franklin Wilkins Building, King’s College London
Waterloo Campus, Stamford Street, London, SE1 8WA
Travel details: Available on our website. / Conference fee: £249.00
Includesa copy of the 12th edition(subject to the production schedule) either on the day or posted, lunch buffet and refreshments. Please see page 2 for a full list of what is included in the fee. Also on our website (registration page)
Date
Tuesday 9th September 2014, 10am-6pm / Confirmation of booking
All bookings will be confirmed by email. Please contact us if you have not received confirmation 5-7 days after submitting your booking form
Payment Details
By cheque
Please make cheques payable to KING’S COLLEGE LONDON.
Cheques must be paid in UKSterling (£). Please ensure the cheque(s) are completed correctly, checking they are signed, dated appropriately and that the words and figures agree with each other.
By invoice
An invoice will be sent to delegate(s) for payment. This is on receipt of completed booking form(s) for each delegate.
Invoice to be sent to:
Person stated on this booking form Yes/No (if yes, please list name(s) of delegate(s) in the below box
If no, please provide:
Full name
Full address / Post Code:
Contact number
Email address
Full name of each delegate
By BACs
Please contact Event Organiser for details
Conference fee includes:
  • Copy of 12th edition of Maudsley Prescribing Guidelines (subject to production schedule)
  • Buffet lunch and refreshments
  • Delegate pack
  • E-certificate of attendance (hard copies available on request)

How did you hear about this event?
Advert in British Journal of Psychiatry / SLaM news
Advert in Therapeutic Advances in Psychopharmacology / Through the KCL e-store
Conference Alerts / Word of mouth
Maudsley Prescribing Guidelines Conference website / Other(please specify)
Institute of Pharmaceutical Science website
Institute of Psychiatry
Please send completed registration forms and cheques to:
Miss Maria O’Hagan, Research and Events Co-ordinator/EA to Professor David Taylor,
Pharmacy Department, MaudsleyHospital, London, SE5 8AZ
Please email or fax completed registration forms to:
Telephone: 020 3228 5026 Fax: 020 3228 2337 Email: