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CONFERENCE REGISTRATION FORM


YOU CAN NOW BOOK ONLINE AT HTTP://EVENTS.SOR.ORG


Please use this form if you wish to attend one or more of the following conferences. Please tick below to indicate which courses you wish to attend:


 Choosing Health & Wellbeing: Improving Working Lives – 11 March & 15 April 2014 An Introduction to the Alexander Technique for Mammographers – 6 May 2014 Advanced Workshop in the Alexander Technique for Radiographers – 17 June 2014


Please fill in all of the form below, as well as the relevant section(s) opposite Forms should be sent to the Conference Team at the SoR (address below) by the deadline date listed.


Are you a SoR member? Yes


No SoR membership No. .............................................................................................................................................. (Discounted members’ prices not valid without membership number )


Title (Miss/Ms/Mrs/Mr) ………… First name .................................................................................................................................................................................... Surname ........................................................................................................................................................................................................................................................ Correspondence address .......................................................................................................................................................................................................................... .......................................................................................................................................................................................................................................................................... .......................................................................................................................................................................................................................................................................... Postcode


Email ..............................................................................................................................................................................


Telephone (home) ...................................................................................Telephone (work) ................................................................................................................. How would you prefer to receive course information?


Email Post


Job title .......................................................................................................................................................................................................................................................... Place of work ............................................................................................................................................................................................................................................... Please tick if you do not want your name, job title and place of work published on the delegate list.


Any special dietary requirements ........................................................................................................................................................................................................... Are there any other facilities you require in order to participate fully in the conference? ...................................................................................................... Total amount being paid £..........................................................


If you wish to receive an invoice, please complete the contact details of your finance department below and attach their official purchase order. FORMS RECEIVED WITHOUT A PURCHASE ORDER WILL NOT BE PROCESSED (this is not required if sending a cheque at time of booking)


Organisation ................................................................................................................................................................................................................................................. Contact name .............................................................................................................................................................................................................................................. Correspondence Address ......................................................................................................................................................................................................................... .......................................................................................................................................................................................................................................................................... Postcode Telephone........................................................................................... Fax ...................................................................................................................................................


I confirm that I wish to book a place at the conference(s) indicated above and have read and agree to be bound by the booking terms and conditions (available on the events section of our website www.sor.org or on request). Signature ...................................................................................................................................................Date .......................................................................................... Please indicate how you heard about this event:


Synergy News SoR website TopTalk Colleague


Other ...................................................................................................................................................................................................................................................... Forms should be sent to:


Conference Team, The College of Radiographers, 207 Providence Square, Mill Street, London SE1 2EW Or Fax: 020 7740 7248


If you have any queries please call 020 7740 7252 or email conferences@sor.org FOR OFFICE USE ONLY


DATE RECEIVED FINANCE NO


EVENT REF FINANCE DATE


AMOUNT NL CODE


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