United Kingdom
Clinical Ethics Network
Annual Conference:
Clinical decision making at the beginning and end of life
Glasgow, 23 June 2011
PLEASE PRINT CLEARLY IN CAPITAL LETTERS
FULL NAME (Title):INSTITUTION:
ADDRESS:
TELEPHONE:
EMAIL:
SPECIAL REQUIREMENTS (DIETARY OR OTHER (e.g. hearing loops, mobility requirements)
/REGISTRATION / CONFERENCE FEE
Registration for the UKCEN Annual Conference(23rd June 2011) includes participant packs with all conference information (programme, abstract booklet, badge, CME / CPE Certificate etc.), provision of local tourist information and booking information for accommodation, meals and refreshments (excluding conference dinner).REGISTRATION
DOCTORS/LAWYERS- £150.00
OTHER - £100.00
REDUCED FEES (£20 Discount)for members of clinical ethics committees who have paid their UKCEN subscription for 2011
Please state name of clinical ethics committee…………………………………………………………………………………
STUDENTS - £25.00
CONFERENCE DINNER: WEDNESDAY 22nd JUNE 2011, 8:00pm- £ 30.00
HOTEL ACCOMMODATION
For further details of hotel accommodation:You can make hotel enquiries by email at or telephone: 0141 330 5385.
UNIVERSITY ACCOMMODATION – BED & BREAKFAST
A limited number of single en-suite bedrooms are available at Glasgow University.
To make an individual residences enquiry, you can email or phone 0141 330 4116.
PAYMENT PLEASE BY CREDIT/DEBIT CARD/ CHEQUE / INVOICE
IF PAYING BY CREDIT OR DEBIT CARD PLEASE COMPLETE THIS SECTION
Please note that only VISA, MASTERCARD AND MAESTRO cards can be accepted.
COMPLETION OF THIS SECTION INDICATES PERMISSION TO DEBIT YOUR CARD.
CARDHOLDER NAME:CARD NUMBER:
EXPIRY DATE:
ISSUE NUMBER/START DATE: / (Maestro Only):
SECURITY NUMBER: / (Last 3 digits on the back of card):
POSTCODE and HOUSE NUMBER:
CHEQUES PAYABLE TO “UKCEN CONFERENCE FUND” PLEASE.
PLEASE PROVIDE INVOICE DETAILS/ADDRESS:
OUR TERMS OF PAYMENT ARE STRICTLY 30 DAYS FROM DATE OF INVOICE
NAME OFPERSON TO WHOM INVOICE SHOULD BE SENT
INSTITUTION NAME FOR INVOICING PURPOSES IF DIFFERENT TO PAGE 1
ADDRESS (FOR INVOICING PURPOSES)
POSTCODE:
THE DEADLINE FOR BOOKING IS6th JUNE 2011. FULL CONFIRMATION OF YOUR RESERVATION WILL THEN BE SENT ONCE PAYMENT HAS BEEN PROCESSED.
PLEASE NOTE FULL REFUNDS ARE AVAILABLE LESS A £20 ADMINISTRATION FEE
UNTIL 6th JUNE 2011 – NO REFUNDS WILL BE GIVEN AFTER THIS DATE.
PLEASE COMPLETE AND RETURN TO:
Lorraine Leask, RHSC,Dalnair Street,Glasgow, G3 8SJ
+44 (0) 141 201 0090 or 07759 716 706
Email:
For office use only
______/ ______/ ______£......
Description to appear on Statement (Name, date of registration, conference name)
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Please note that no information is passed to any other organisation and we do not keep a record of your credit card details on a database.
If you require a CPE/CME Certificate please tick