THE UK NATIONAL CONFERENCE

ON

THE FUTURE OF CUSTOMER INSIGHT IN RETAIL BANKING

5TH JULY 2004

 

DELEGATE REGISTRATION FORM

 

 

SECTION 1: PERSONAL DETAILS:

 

Title:…………Name:…………………………………….Organisation:………………………...

(BLOCK CAPITALS PLEASE)

Mailing Address:………………………………………………………………………………....

…………………………………………………………………………………………………...

…………………………………………………………………………………………………...

Telephone:....................................Facsimile:....................................Email.:.......................………...

 

SECTION 2: REMITTANCE (Please complete schedule overleaf for details):

A remittance of £........................, payable in the form of sterling cheque(s) or money order (i.e. Western Union, American Express, etc.) made payable to Heriot-Watt University is enclosed.

OR

Address of company representative who is authorised to be responsible for payment of fee and to whom invoice should be sent:

…………………………………………………………………………………………………...

…………………………………………………………………………………………………...

…………………………………………………………………………………………………...

Purchase Order Number………………………………………………………………………

[N.B. We do not offer a credit card facility, as there is a significant cost involved in processing credit card payments. However, if this presents a problem, please email FCIRB@macs.hw.ac.uk and we will endeavour to help, although this may incur extra costs for the delegate.]

 

Signature:................................................................................…….. Date:……………….…………

 

SECTION 3: DIETARY REQUIREMENTS (Please tick all that apply):

Vegetarian Vegan Low Fat Gluten Free Other (please specify below)

…………………………………………………………………………………………………...

…………………………………………………………………………………………………...

…………………………………………………………………………………………………...

 

SECTION 4: DELEGATE DETAILS:

Please tick which of the following applies in your case and insert appropriate amount (prices are detailed on the conference web site):

 

 

 

Value

£

Conference Fee: First Delegate, full (£500/£600)†

 

Conference Fee: Subsequent Delegate, full (£400/£500)†

 

Conference Fee: Academic Delegate, full (£300/£350)†◊

 

 

Total Payable

 

 

 

†      Delete as appropriate – Fee for registration by 1st June 2004 / fee for registration after 1st June 2004

 

      Delegates registering as students, please enclose a letter from your institution to confirm your status as a full-time student.

 

 

SECTION 5: REGISTRATION DETAILS AND CANCELLATION:

If you have to cancel, please confirm to the conference administrator as soon as possible. All cancellation notices received and acknowledged up to 15 working days before the conference event will receive a refund less a 15% service charge. No refunds can be accepted for cancellations received less than 15 working days before the conference. Substitutions from the same organisation may be made at any time, but must be communicated to the conference administrator before the date of the conference.

 

 

SECTION 6: REGISTRATION CONTACT DETAILS:

Please return this form as soon as possible to:

 

Postal Address:     Mrs Claire Porter, Administrator, School of Mathematical and Computer Sciences, Heriot-Watt University, Riccarton Campus, Edinburgh EH14 4AS, U.K.

Telephone:           +44 (0)131-451-3411

Facsimile:             +44 (0)131-451-3327

Email:                  claire@macs.hw.ac.uk.