Registration Form

To register please complete and return the registration form below. At present online registration is not possible.

Fax to:
+44 (0) 1865 843958

Mail to:
Charlotte Wilkins, Hybrid Materials Conference Secretariat, Elsevier Ltd., The Boulevard, Langford Lane, Kidlington, Oxford, OX5 1GB, UK

Please register me for Hybrid Materials 2009

Delegate Details
 

Please tick this box if you do not wish your name and affiliation to be included in the list of attendees given to delegates at the meeting.

Please tick this box if you do wish your email address to be given out to delegates of this conference, in the knowledge that it may be used by them for future 3rd party mailings.

Presenters should provide their abstract reference number in order to ensure that their material is included in the final program and abstract book: [e.g. HYMA] Ref:

Please send me information on exhibition and sponsorship opportunities at the congress

Registration Rate

Earlybird registrations received on or before 16 January 2009
Early Academic Participant Registration¹ - €495 plus VAT @19.6% = €592.02
Early Industrial Participant Registration- €695 plus VAT @19.6% = €831.22

Student registrations
Student Participant Registration² - €295 plus VAT @19.6% = €352.82

Late registrations received after 16 January 2009
Academic Participant Registration¹ - €570 plus VAT @19.6% = €681.72
Industrial Participant Registration - €770 plus VAT @19.6% = €920.92
¹Academic rate applies to those with a fulltime position in a non-commercial institute.
²Student rate applies to those registered for a higher degree. Student registration forms must be accompanied by a signed letter from your head of department attesting to student status.

Please book me conference dinner tickets @ €65.00 + VAT @ 19.6% = €77.74 per ticket

Payment Details
 

Declaration
(Please note that unsigned forms cannot be accepted)

I have read and agree to abide by the payment and cancellation terms, and I understand that this form confirms my conference booking. I accept that from now on charges will be imposed for cancelled registrations, and that up to the full registration fee will be payable if I am unable to attend the conference for any reason.

Signed:

______________________________________________

Date:

______________________________________________

The personal information that you provide on this form will be used by Elsevier Limited, (a company registered in England and Wales with company number 1982084, whose registered office is The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, UK, conferenceinfo@elsevier.com) and its offices worldwide to process your registration.

We use your credit card and billing address details to bill you for the purchase and, where necessary to process the transaction, will pass this information on to relevant third parties. Your credit card information is used only for completing the purchase transaction and is retained only as necessary for administration purposes

The contact information you have provided may, with your permission, be used by us and affiliated and non-affiliated third parties for marketing purposes. We respect your privacy and do not rent, sell or disclose your personal information to any non-affiliated third party without your consent.

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