Techshare Europe 2014:
Technology for Life
4-5 September 2014
Glasgow Science Centre
DELEGATE BOOKING FORM
To book a place please complete the following form or alternatively book online at 11 July 2014
If you have any queries, require an alternative accessible format or assistance completing the form, please contact 0131 652 3140 or email
Please complete all form fields or we may not be able to process your booking.
1. Your details
Title:
First Name
Last name:
Job title (if attending as an individual please enter N/A):
Organisation (if attending as an individual please enter N/A):
Address 1:
Address 2:
Town / City:
Postcode:
Telephone:
Email:
I agree to my name, job title and organisation being featured on the delegate list[Yes / No]:
Communication requirements
[Please enter “Yes” after each requirement which you have]
Clear print and email:
Large print 18pt and email:
Braille and email:
Audio and email:
Hearing Loop:
BSL:
Other – please detail:
Access requirements
[Please enter “Yes” after each requirement which you have]
None:
Accompanied by sighted guide - please provide name [no charge]:
Sighted guide requested:
Guide dog facilities:
Wheelchair access:
Other– please detail:
Dietary requirements
[Please enter “Yes” after each requirement and provide details for any accompanying sighted guide]
None:
Vegetarian:
Vegan:
Halal:
Food intolerance / allergies / other – please detail:
2.Attendance and payment details
Attendance
[Please enter “Yes” after the relevant option]
Conference package: 4 and 5 September (including dinner) - £130:
4September only (not including dinner) - £40:
4September only (including dinner) - £80:
5 September only - £80:
RNIB members, volunteers and students are entitled to a 50% discount.
[Please enter “Yes” after the relevant option]
RNIB Member:
RNIB Volunteer:
Student – please provide name of educational establishment:
Debit/credit card payments
Please request an invoice. The invoice will provide details on how to pay by debit /credit card.
Invoice [Note: it is essential that all fields are completed]
Contact Name (for invoice payment):
Organisation (if attending as an individual enter N/A):
Billing Address 1:
Billing Address 2:
Town / City:
County:
Postcode:
Telephone:
Email:
Purchase orders
Purchase Order number (if attending as an individual or if organisation is unable to issue a PO enter N/A):
NOTE: A copy of any PO must be emailed to in order for the invoice to be raised.
RNIB Internal Transfer
Contact Name (to authorise IT):
Cost code (including nominal code):
Terms and Conditions
- Please complete this form in full by 27 August 2014 and return it by email to , or post to: Techshare Europe 2014, RNIB Scotland, 12-14 Hillside Crescent, Edinburgh, EH7 5EA. Please call 0131 652 3140 if you require any assistance.
- Please note places are limited and will be treated on a first come first served basis. You will receive confirmation of receipt of your booking by email within 5 working days. If you do not receive confirmation within this timeframe, please contact or call 0131 652 3140 as this means your booking has not been received. Please note that your booking is not guaranteed until payment has been received.
- Cancellations will be charged at full cost if less than 2 weeks’ notice is given. Alternatively your organisation may provide a substitute delegate.
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