Delegate Registration form

Form suitable for practice or individual registrations

Remember: for early bird prices we must receive your form by 1st May

Practice/Place of Work
Address (inc. post code) / Place of work
Legible E-mail / Email address
Telephone (mobile) / Mobile number / Telephone / Home Telephone
Invoice/Receipt for spouses (below) and delegates registered overleaf should be addressed to :
The Practice/Place of work ☐ The Individual delegate(s) ☐

Notes on completing this form

Confirmation of receipt will be sent by e-mail to the address given above.

Vet and Nurse Lecture Registration Includes

- access to lecture programme

- delegate notes (vet or nurse as appropriate)

- lunch and breaks on the day(s) registered

Registration prior to the weekend is preferred—anyone registering after midday on 21st May will be classed as a “walk in” delegate and will be subject to a £25 administrative fee

Places at the Advanced lectures (Saturday) are limited and will be reserved on a first-come,

first-served basis. Tick appropriate box overleaf to indicate which vets would like to attend these.

Spouses/partners can purchase Party Night tickets. To join delegates in the Trade Exhibition and

access tea and coffees, spouses must also purchase a lunch ticket. Book spouses meals below.

Payment - either:

- Calculate total due, make cheque payable to AVSPNI and post with form to:

AVSPNI Conference Organiser, VetNI, 6 Ross Green Lane, Kells, Ballymena, BT42 3JA

or:

- Submit form and the conference organisers will calculate the sum owing and e-mail you/your practice an invoice along with the confirmation of your registration.

Nurses who are both current BVNA members AND from an AVSPNI Practice get the best lecture registration prices. An AVSPNI practice is defined as a practice that pays for 2 or more vets by a single practice direct debit.

Hotel Accommodation - Don’t forget to book your rooms directly with La Mon Hotel

by calling their reservation line on +44 (0) 2890 448631or by e-mailing

Mention “Vet Conference” to get conference room rates

Book meals for spouses/partners here:

Name of spouse/partners / Friday Lunch & Breaks
£30 / Friday Wild West
Party Night £50 / Saturday Lunch & Breaks £30
Name of spouse/Partner / ☐ / ☐ / ☐
Name of Spouse/Partner / ☐ / ☐ / ☐
Name of Spouse/Partner / ☐ / ☐ / ☐
TOTAL due from this page £Please enter total amount
Vet Lecture Registration
Includes lunch & breaks for each full day booked / EARLY BIRD PRICES
Registrations received BEFORE1st May / Registrations received AFTER 1st May / Advanced lectures (Saturday) / Wild West Party Ticket £50
AVSPNI Members / Non AVSPNI
Members / Recent Graduates (2014) onwards or Vet Students / AVSPNI Members / Non AVSPNI
Members / Oral cancer - Part 1 / Feline oral conditions / Fits & Faints / Oral cancer - P art 2
Name of Vet/Vets / WholeWeekend
£180 12.5 VCI Credits / Friday Only
£120 6.5 VCI Credits / Saturday Only
£120 6 VCI Credits / WholeWeekend
£270 12.5 VCI Credits / Friday Only
£180 6.5 VCI Credits / Saturday Only
£180 6 VCI Credits / WholeWeekend
£125 12.5 VCI Credits / Friday Only
£95 6.5 VCI Credits / Saturday Only
£95 6 VCI Credits / WholeWeekend
£270 12.5 VCI Credits / Friday Only
£180 6.5 VCI Credits / Saturday Only
£180 6 VCI Credits / WholeWeekend
£360 12.5 VCI Credits / Friday Only
£240 6.5 VCI Credits / Saturday Only
£240 6 VCI Credits
Name of Vet. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Name of Vet. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Name of Vet. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Name of Vet. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Name of Vet. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Nurse Lecture Registration
Includes lunch & breaks for each full day booked / EARLY BIRD PRICES
Registrations received BEFORE1st May / Registrations received AFTER 1st May / Wild West Party Ticket £50
BVNA AND AVSPNI Practice Members / BVNA OR AVSPNI Practice Members / Non-members from non-AVSPNI practice / BVNA AND AVSPNI Practice Members / BVNA OR AVSPNI Practice Members / Non-members from non-AVSPNI practice
Name of Nurse/Nurses / BVNA
members
include your
membership
number here / WholeWeekend
£10012 .5VCI Credits / Friday Only
£80 6.5 VCI Credits / Saturday Only
£80 6 VCI Credits / WholeWeekend
£120 12 .5VCI Credits / Friday Only
£90 6.5VCI Credits / Saturday Only
£90 6 VCI Credits / Whole Weekend
£150 12.5 VCI Credits / Friday Only
£1106.5 VCI Credits / Saturday Only
£1106 VCI Credits / WholeWeekend
£130 12.5 VCI Credits / Friday Only
£1006.5 VCI Credits / Saturday Only
£100 6 VCI Credits / WholeWeekend
£150 2.5 VCI Credits / Friday Only
£110 6.5 VCI Credits / Saturday Only
£110 6 VCI Credits / Whole Weekend
£190 12.5 VCI Credits / Friday Only
£130 6.5 VCI Credits / Saturday Only
£130 6 VCI Credits
Name of Nurse / BVNA membership no. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Name of Nurse / Click here to enter text. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Name of Nurse / Click here to enter text. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Name of Nurse / Click here to enter text. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Name of Nurse / Click here to enter text. / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐