BAPO Conference 2008 Registration Form

BRITISH ASSOCIATION OF PROSTHETISTS AND ORTHOTISTS Annual Conference, De Vere Whites Hotel, Bolton.

14 - 16 March 2008

General Information : All Conference attendees should complete this form. Please use one form per person.

Deadline dates and penalties : Your completed form, with payment, to baPo Ltd to arrive by 29 February 2008

Financial Information : Receipts for payment will be issued to each individual attendee. We will not accept this form without full payment of the grand total. Please do not include payment for anything else – Conference payment only.

If your employer is meeting all or part of your conference costs:-

• Please treat this form as a temporary invoice and pass it to your employer’s finance department for cheque requisitioning.

• We regret that baPo Ltd is unable to issue invoices to individual employers. Instead, we will issue a receipt to each individual attendee upon payment. It will be each attendee’s responsibility to copy it to their employer.

• Where an employer is meeting the costs of several attendees, payment for the accumulative total should accompany all registration forms. For example, for 6 attendees from one Company, return 6 forms with one Company payment for the combined grand total.

IMPORTANT INFORMATION PLEASE READ AND COMPLY: Take your time. Entries in this form are necessary to facilitate the smooth production of delegate and exhibitor badges and other items. Please give your name, discipline and employer as you would like them to appear on your delegate/exhibitor badge. Please review all of your entries BEFORE submitting the form, if you do not and you receive an error message, you may have to fill in all the details again. IMAGE VERIFICATION: To protect your data and ours from spammers, this form is protected by image verification. It is very important that you enter the characters displayed accurately before submitting the form, or you could lose your data. Once you succesfully send the registration form, you will receive confirmation by email which will contain all the details you have submitted. You will also be immediately redirected to the BAPO shop where you can buy your tickets, online. Use your confirmation email to decide what items you need to buy. If in any doubt, please contact the secretariat BEFORE any purchases are made. PLEASE NOTE: Any errors or ommissions are entirely your own responsibility. BAPO staff cannot be held responsible for inaccurate information submitted via this form. If you think you may have made an error in your form submission, or subsequent checkout, please contact the secretariat immediately, DO NOT attempt to resend the form.

	* = Required Fields
Number of Registrations:	*
Cardholder Name:	*
Cardholder Email:	*

Registration Form 1
Title:		Telephone:	*
First Name:	*	Email:	*
Surname:	*	BAPO Member No. (if applicable):
Discipline:	* If other, please specify:
Employer:	*	Delegate or Exhibitor:	*
Attending As:	*	Casino Party Night No. of Tickets:
Address for Correspondence:	*	Guest(s) Name(s):
Special Needs, and/or Dietary Requirements:

Registration Form 2
Title:		Telephone:	*
First Name:	*	Email:
Surname:	*	BAPO Member No. (if applicable):
Discipline:	* If other, please specify:
Employer:	*	Delegate or Exhibitor:	*
Attending As:	*	Casino Party Night No. of Tickets:
Address for Correspondence:		Guest(s) Name(s):
Special Needs, and/or Dietary Requirements:

Registration Form 3
Title:		Telephone:	*
First Name:	*	Email:
Surname:	*	BAPO Member No. (if applicable):
Discipline:	* If other, please specify:
Employer:	*	Delegate or Exhibitor:	*
Attending As:	*	Casino Party Night No. of Tickets:
Address for Correspondence:		Guest(s) Name(s):
Special Needs, and/or Dietary Requirements:

Registration Form 4
Title:		Telephone:	*
First Name:	*	Email:
Surname:	*	BAPO Member No. (if applicable):
Discipline:	* If other, please specify:
Employer:	*	Delegate or Exhibitor:	*
Attending As:	*	Casino Party Night No. of Tickets:
Address for Correspondence:		Guest(s) Name(s):
Special Needs, and/or Dietary Requirements:

Registration Form 5
Title:		Telephone:	*
First Name:	*	Email:
Surname:	*	BAPO Member No. (if applicable):
Discipline:	* If other, please specify:
Employer:	*	Delegate or Exhibitor:	*
Attending As:	*	Casino Party Night No. of Tickets:
Address for Correspondence:		Guest(s) Name(s):
Special Needs, and/or Dietary Requirements:

Registration Form 6
Title:		Telephone:	*
First Name:	*	Email:
Surname:	*	BAPO Member No. (if applicable):
Discipline:	* If other, please specify:
Employer:	*	Delegate or Exhibitor:	*
Attending As:	*	Casino Party Night No. of Tickets:
Address for Correspondence:		Guest(s) Name(s):
Special Needs, and/or Dietary Requirements:

Registration Form 7
Title:		Telephone:	*
First Name:	*	Email:
Surname:	*	BAPO Member No. (if applicable):
Discipline:	*If other, please specify:
Employer:	*	Delegate or Exhibitor:	*
Attending As:	*	Casino Party Night No. of Tickets:
Address for Correspondence:		Guest(s) Name(s):
Special Needs, and/or Dietary Requirements:

Registration Form 8
Title:		Telephone:	*
First Name:	*	Email:
Surname:	*	BAPO Member No. (if applicable):
Discipline:	* If other, please specify:
Employer:	*	Delegate or Exhibitor:	*
Attending As:	*	Casino Party Night No. of Tickets:
Address for Correspondence:		Guest(s) Name(s):
Special Needs, and/or Dietary Requirements:

Registration Form 9
Title:		Telephone:	*
First Name:	*	Email:
Surname:	*	BAPO Member No. (if applicable):
Discipline:	* If other, please specify:
Employer:	*	Delegate or Exhibitor:	*
Attending As:	*	Casino Party Night No. of Tickets:
Address for Correspondence:		Guest(s) Name(s):
Special Needs, and/or Dietary Requirements:

Registration Form 10
Title:		Telephone:	*
First Name:	*	Email:
Surname:	*	BAPO Member No. (if applicable):
Discipline:	* If other, please specify:
Employer:	*	Delegate or Exhibitor:	*
Attending As:	*	Casino Party Night No. of Tickets:
Address for Correspondence:		Guest(s) Name(s):
Special Needs, and/or Dietary Requirements:

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