ࡱ> UWTY'` bjbj"9"9 x|@S@S 0NNNN$j*j*j*P*<*lGtn,,,,,---GGIGIGIGIGIGIG$T?,b, |pj*0|o>BlG0G}>L!1~L??\Lw?d-L%.6 3[.,.f---mGmG2j---G//// NNNNNN Fragments IV Monday-Tuesday, 4th-5th March 2013 at STFC, Harwell Delegate Registration Form TitleFirst NameSurnameJob titleOrganisationAddress TelMobileE-mailIf you have any special requirements, eg dietary, please detail below:If you are claiming ŷAV member rate, please insert your membership numberPlease indicate Yes or NoTransport: I plan to use the free transport between:Sunday afternoon - venue to hotelsYes/NoMonday morning - Didcot railway station and venueYes/NoMonday morning - hotels and venueYes/NoMonday evening - venue and hotels (after conference dinner)Yes/NoTuesday morning - hotels and venue Yes/NoTuesday afternoon - venue and hotels Yes/NoTuesday afternoon - venue and Didcot railway station Yes/NoI require parking at STFC on Sun / Mon / Tue (indicate days) Car registration number Extra Activities: I would like to attend the pre-event Training Course (Sun)Yes/NoI will attend the conference dinner (Mon) included in registration feeYes/NoI would like to join a tour of the Diamond Lightsource Synchrotron (Tue)Yes/No / continued overleaf Registration Fees include conference dinner (no VAT)Up to 30 Dec31 Dec to 31 JanIndicate feeMember of the ŷAV290350Non-member370440Student member of the ŷAV (undergrad or post-grad)145175Student non-member (undergrad or post-grad)185220Late booking fee (payment received by the Secretariat after 31st Jan) 50Exhibition trade stand (excluding delegate) fixed rate 750Payment 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 "http://www.maggichurchouseevents.co.uk/bmcs" www.maggichurchouseevents.co.uk/bmcs)Yes/NoPlease note that your e-mail address will be included in the List of Participants unless you indicate otherwiseInclude Please note that places are limited on the pre-event training course and on the tours of the Diamond Lightsource Synchrotron. They will be allocated on a first come, first served basis. 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