Bath Profile Meeting

BOOKING FORM

Please use a separate form for each individual application. If a hard copy of this form is used, please return it to Sara Hassen at UKOLN.

This booking form constitutes a legally binding contract. In the unlikely event of the conference being cancelled, the organisers will make a full refund of the booking fee where applicable but disclaim any further liability.

Fields marked with an asterisk (*) must be completed.

Personal Information

Conference Name: Bath Profile Four Years On; 7th July, Francis Hotel, Bath

Title:

First name: *

Family name/Surname: *

Job title:

Organisation: *

Address line 1:*

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Address line 3: *

Address line 4: *

Town/City: *

Postcode/Zipcode: *

Country:

Email:

Telephone: [daytime] *

Please include area code and country code if outside the UK

Fax:

Special Needs

Do you have any special needs, such as dietary or mobility requirements?:

Payment *

Please indicate your chosen method of payment, where required *. All payments must be made in UK sterling.

Payment

Cheque or banker's draft, made payable to the University of Bath

Credit card (Visa or MasterCard only).
This site does not offer secure payment facilities.
To ensure security you can contact Sara Hassen tel: +44 (0)1225 38 6256 with your credit card details. You must state your name as it appears on the card, expiry date and card number

Bank transfer to National Westminster Bank, 39 Milsom Street, Bath, BA1 1DS, UK (Bank sort code: 60 02 05 - Account number 50972146)
Please note if using bank transfer that the bank charge of £6 must be added to the booking fee

Please give below address to which invoice should be sent

Address line 1:*

Address line 2: *

Address line 3: *

Address line 4: *

Town/City: *

Postcode/
Zipcode: *

Country:

For all enquiries with regard to the conference, please contact:

Sara Hassen, Events & Marketing Manager,
UKOLN, The Library, University of Bath,
Claverton Down, Bath BA2 7AY, UK
tel/fax: +44 (0)1225 38 6256;
e-mail: s.hassen@ukoln.ac.uk

The Data Protection Act 1998

The information supplied on this form will be retained by UKOLN on a database and will be used to compile either a paper delegate list to be distributed at the event, or an electronic delegate list on the web. The information may also be used for marketing purposes and you could be contacted by letter, fax, telephone or E-mail with details of future events and courses organised or promoted by UKOLN which may be of interest to you.
Do you wish to receive such further information? Please select. Yes or No