RSS EVENT BOOKING FORM
New Challenges for Observational Studies
Wednesday 12February2014, 1.30pm – 5.15pm
The Royal Statistical Society, 12 Errol Street, London, EC1Y 8LX

Name

Address(for correspondence)
E-mail address / Tel. No.
Affiliation
RSS Membership No. ______(if applicable)
Please tick relevant box / FEES (including a sandwich lunch and afternoon tea and coffee)
 £25for RSS Retired Fellows/Student Fellows/EDA Fellows
 £27 for RSS CStats N.B.The CStat rate applies to MIS, FIS and GradStat
 £30for RSS Fellows
 £45for RSS Linked Associates, Student Members, Section members
 £60 for none of the above
PAYMENT / I enclose a cheque for £_____ payable to “The Royal Statistical Society”
Please invoice me/my organisation at the following address:
Purchase order number (if applicable) ______
(Please note invoices will only be issued if requested at least one month prior to the event taking place)
Please debit my credit card for the amount of £______
Type of card: Visa / Mastercard / AMEX / Registered address, house number:
Card number: / Postcode:
Expiry date: / Name on card:
3 digit security number (on back of card): / Signature:
ADDITIONAL REQUIREMENTS - Please tick boxes applicable, if you:
Require a vegetarian lunch  Require any special diet  Require a receipt 
Please return to: / Conference Office, The Royal Statistical Society, 12 Errol Street, London, EC1Y 8LX
Fax: 020 7614 3905 E-mail: Tel: 020 7614 3918

VAT number: 766 0161 36

Booking: completed forms are processed on a first-come-first-served basis. Final confirmation will only be sent once payment has been received.

Cancellation: if you cancel your place more than 1 month before the meeting date, we will refund the fee (less an administration charge). If you cancel your place between 1 month and 2 weeks of the meeting date, we will refund 50% of the fee. If you cancel your place within 2 weeks of the meeting date, you are liable for the full fee and there will be no refund. By completing this order form you are accepting these cancellation terms.

The RSS will hold your personal data on its computer database. This information may be accessed, reviewed and used by the organisation for the purpose of running this and future events you choose to attend. The RSS may also periodically send you information you may be interested in. If you do not wish to receive such information, please tick this box