Functional Oxides
RSC spring Solid State Group meeting
Chemistry Department, UniversityCollegeLondon, UK
14-16 April 2008
For Official use only: / Oral or Poster Presentation / Speaker / Student Award / Fees
Paid / Amount Outstanding / Cheque No / Reg No
Personal details(Please print clearly below)
Title (Prof, Dr, Mr, Mrs, Miss, Ms)
Firstname / Middle initials / Lastname
Organisation
Mailing address
Postcode / Email
Tel No / Fax No
Affiliation for the badge
Registration fees
The registration fee includes attendance at the sessions, delegate pack, lunch on 15 and 16 April, drinks reception with the poster session on 14 April, conference dinner on 15 April, refreshments throughout the meeting, costs for catering staff and stewards, admin fee and VAT.
Member of RSC/SSG / Fee:Early Bird Registration Fee £125
Standard Registration Fee: £145 / £ .
Non-Member / Fee: Early Bird Registration Fee £145
Standard Registration Fee: £165 / £ .
£ .
Symposium fee includes Lunch 15 April, refreshments x 2, Conference Dinner, admin fee & VAT)
Bill Mackrodt Symposium only / Fee: Early Bird Registration Fee £85
Standard Registration Fee: £105
Total / £ .
Payment
ATTENDANCE AT THIS MEETING IS BASED ON PRE-PAYMENT ONLY
The method of payment is in UK Pound Sterling (GBP). All cheques are payable to the ‘UniversityCollegeLondon’
The cheque and registration form(s) must be sent to: Shazia Riaz, Davy Faraday Research Laboratory (DFRL), 3 Floor, KathleenLonsdaleBuilding, University College London, Gower Street, London WC1E 6BT
Early Bird closing date: Monday 3 March 2008Standard closing date: Wednesday 19 March 2008
The VAT registration number for UCL is: GB 524 3711 68
Special requirements
Please indicate here details of any special diets, disability or any other requirements
Presentations
Oral Presentation / □Tick here if you wish to give a CONTRIBUTED TALK (you must attach an abstract with the form)
Poster Presentation / □Tick here if you wish to give a POSTER presentation (you must attach an abstract with the form)
Please print the title of your oral ORposter presentation here:
SSG Student Award
□ Tick here if you wish to be considered for an SSG Student Award.
Important: Students applying for an SSG Student Award must present a poster. Please return a completed application form with a poster abstract. Do not provide any payment until after we have contacted you to confirm the offer of an award.
Data Protection Statement
The DFRL will use the information you supply for the provision and administration of its activities and for marketing. It may be necessary to disclose your information to service providers. A list of participants, which will include email addresses, will be published for distribution at the conference. If you do not wish to be included in this list please tick this box: □
Your name, address and email will be passed on to organisers of other related meetings. If you do not wish your details to be forwarded
please tick the box: □
Terms and conditions
Attendance at this meeting is based on pre-payment only. All payments must be received before the start of the conference in order to confirm your booking.
Cancellations received before 31 March 2008 will be subject to a £30 cancellation fee. Any cancellations received AFTER 31 March, no refund will be made.
EARLY BIRDDeadline: Monday 3 March 2008
STANDARD Deadline: Wednesday 19 March 2008
Fax Form to: +44 (0)20 7679 0493 (Attn: Shazia Riaz)
SignatureDate:
The Davy Faraday Research Laboratory (DFRL)
3rd Floor, KathleenLonsdaleBuilding, UniversityCollegeLondon, Gower Street, London WC1E 6BT5
Tel: +44 (0)20 7679 2979 | Fax+44 (0)20 7679 0493 | email: