SEEC professional development seminar reservation form

Reservation form for SEEC Professional Development Seminar

HEAR - Would you credit it?

Thursday 18th March 2010, The Women's Library, London Metropolitan University

Please fill in one form for each applicant, and submit it to SEEC using the button at the end of the form. We will then email to confirm your reservation. Payment is by cheque to accompany the booking, or we will invoice your institution, in which case, please include a purchase order number. We would normally send this to you for passing on.

* these items are required as a minimum

Contact details

Title
First name *
Family name*
Institution *
Position *
Address 1 *
Address 2
Address 3
Town/city
County
Postcode *
Email *	Email required
Phone number
Mobile
(in case we have to contact you at the last minute)
Fax
Are you able to receive updates via email immediately prior to the event?
Yes No

Payment options

Fee *
I am from a member institution and the fee is £80 I am from a non-member institution and the fee is £160
Please indicate which payment option you wish to use *
I will post a cheque to SEEC office within 5 working days (address) Please invoice my institution: purchase order no:

We do not normally offer refunds if you have to cancel with less than 15 working days notice. Substitutions are welcomed if you are not able to come; please let us know any changes as soon as possible.

Special requirements

Please note any dietary needs, or any condition of which we should be aware (mobility, special resource needs for vision or hearing, etc)


Data protection

Your details will be put onto SEEC's database and we will email you any further details when your place is confirmed. We will also include you in future mailings about SEEC events, unless you click the 'No' button below. We will not pass your details on to third parties. Yes No

Are you happy for the following contact information to be shared with others attending the event:
Your email address	Yes No
Your postal address	Yes No
Your daytime phone	Yes No

Useful information


How did you hear about this SEEC event? (choose one)




Check and send

I accept the conditions stated in the course/event information and on this form *
Please check your details then click the button below to send in your booking. After clicking 'send' you will be shown a page confirming that we have received your reservation. You may wish to print the details. If you do not see this page your reservation has not been sent. In the event of problems with your booking please email administration@seec.org.uk or leave a voice message on 0845 217 7749.