ࡱ>   *bjbj x|}}   ]]]$PLT*7q:6666666$8x;z6]jjj6  ;6"""jd 8]6"j6""u0hE1ՉQi2p0660*70;>; 11;]12dZD@"466< J*7jjjj; : 6th Ion Channels as Therapeutic Targets Monday-Tuesday, 24th-25th February 2020 at the Wellcome Genome Campus Conference Centre, Cambridge, UK Delegate and Exhibitor Registration Form TitleFirst NameSurnameJob titleOrganisationAddress TelMobileE-mailIf you have any special requirements, eg dietary, please detail below:MembershipAre you are ŷAV or SCI member? Please edit the boxŷAV/SCIIf you are claiming the member rate, please insert your membership numberCar ParkingI require car parking at the Wellcome Trust on Sunday Yes/NoI require car parking at the Wellcome Trust on Monday Yes/NoI require car parking at the Wellcome Trust on TuesdayYes/No Conference Dinner: I will attend the conference dinner (Monday) included in registration feeYes/No / continued overleaf Registration Fees include conference dinner (no VAT)Up to 29 Nov30 Nov to 22 JanIndicate feeMember of the ŷAV or SCI300330Non-member350390Student member of ŷAV or SCI (undergrad or post-grad)135150Student non-member (undergrad or post-grad)160170Late booking fee (payment received by the Secretariat from 23rd Jan) 50Exhibition trade stand, including one full delegate fixed rate 900Exhibition stand staff, including conf dinner (no access to technical sessions)250 Accommodation You may book bed and breakfast accommodation at the Wellcome Trust on Sunday and Monday, 23rd and 24th February via  HYPERLINK "https://www.speedybooker.com/en-GB/book/rooms.aspx?v=wellcomegenome&brand=wl&partnerid=602&lang=en" this weblink. Please use the booking code of ŷAV18327.Payment Options a) I enclose a cheque made payable to Maggi Churchouse Events Please send an invoice for payment by bank transfer name for invoice is: c) I will register online ( HYPERLINK "https://www.maggichurchouseevents.co.uk/bmcs" https://www.maggichurchouseevents.co.uk/bmcs) Yes/NoPlease note that your e-mail address will be included in the printed (not electronic) Attendee List unless you indicate otherwiseIncludeI would like to receive very occasional e-mails from Maggi Churchouse Events about future related ŷAV BMCS events and activities. (Please note that if you select 'no' this will supersede any previous permission and remove you from all contact lists.)Yes / No Cancellation Policy In the event of cancellation before 10th February 2020, 80% of the fee paid will be refunded. Cancellations must be received in writing. Refunds will not be possible from 10th February although substitutions are possible at any time. In the unlikely event of cancellation of the meeting, fees paid will be refunded in full. Registration acknowledgements will be sent within two weeks. 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