TOWARD THE FUTURE

The launch of the new Grades 4 & 5 syllabi

3 January 2014,Mermaid Conference & Events Centre, London

BOOKING FORM

Full name
Membership number (if applicable)
Address
Postcode / Country
Telephone / Email
Dietary requirements (for post-event reception)
Additional requirements
☐I have read and agreed to the terms and conditions
Signature

Delegate rates (including VAT where applicable) Code: 15-CONF-1801 Vat Code E

Please select the amount you are paying:

☐RAD member rate: £115

☐Non-member rate: £185

Payment method

☐Cheque/bank draft:made payable to ‘Royal Academy of Dance’

☐Card: ☐MasterCard ☐Visa ☐Amex ☐Switch ☐Delta ☐Maestro

Card number
Start date / Expiry date / Security code / Issue number
Name on card

☐Bank transfer (sterling transfers only) – reference NAME and MEMBERSHIP NUMBER

Account name: Royal Academy of Dance

Bank name: HSBC plc

Branch name: 31 Holborn Circus, London EC1N 2HR

Account number: 81783521

Sort code: 40-03-28

SWIFT code: MIDLGB22

IBAN GB91MIDL40032881783521

Terms and conditions

Payment must be received in full prior to the event. We are not responsible for the non-arrival of confirmation documents; if, by 14 days prior to the event, you have not heard from us, please call us on the number below. Please note payments will be banked within 14 days of receipt and bookings will be dealt with in order of receipt. Places are subject to availability and shall be processed on a first come first served basis. Cancellations made before 3 December 2013 will incur a 10% administration fee. After this date no refunds will be given. The RAD reserves the right to alter the advertised programme.

Data protection

In providing the Royal Academy of Dance Group with your contact details you give us permission to contact you in relation to the business of the Academy, and we will not disclose your information to any third parties except where legally required to do so.

If you do not wish to receive this information please tick here ☐

We may, from time to time, contact you individually about other carefully selected third party services which we think may be of interest to you.

If you wish to receive this information please tick here ☐

To register

Please complete all relevant sections on this form and return by 13 Decemberto:

Sarah-Jane Lewis, Lead Events Officer

Royal Academy of Dance, 36 Battersea Square, London SW11 3RA

E:T: +44 (0)20 7326 8051F: +44 (0)20 7924 3129

Royal Academy of Dance is a charity registered in England & Wales No. 312826VAT No. GB 603 1763 71