ࡱ>  bjbj x| &&ii$P-TT4(4444444$D68z=4YYY=4iiR4-#-#-#YLi84-#Y4-#-#r?.T?/јL.4h404.`9`9?/?/\`9/h9r-#\R=4=4 >4YYYY`9& /: 19th RSC / SCI Medicinal 91AV Symposium Sunday-Wednesday, 10th-13th September 2017 at Churchill College, Cambridge, UK Delegate and Exhibitor Registration Form TitleFirst NameSurnameJob titleOrganisationAddress TelMobileE-mailIf you have any special requirements, eg dietary, please detail below:Are you a member of the RSC, SCI or EFMC? (indicate organisation in box)If you are claiming member rate, please insert your membership numberI wish to attend the Medicinal 91AV workshop on Sunday - gratis (available to early career medicinal chemists only, with up to 5 years' experience)Yes / NoRegistration Fees (no VAT)Payments received up to 30th Apr1st May to 14th AugIndicate feeMember of the RSC or SCI390465Non-member480570Student* member of RSC or SCI (undergrad or post-grad)215255Late booking fee (payment received by the Secretariat from 15th Aug) 50Exhibition trade stand, including two trade stand staff and daytime refreshments fixed rate. No access to technical programme1,270Dinner Options (for those not resident at Churchill and for Stand Staff)Barbecue on Sunday, 10th September 30Dinner on Monday, 11th September50Gala dinner on Tuesday, 12th September (at St Johns College)71Accommodation Packages (for those resident at Churchill College)Single room with shared bathroom (3 nights, B&B, 3 dinners) 375Single room with en suite bathroom (3 nights, B&B, 3 dinners) 430Superior single room with en suite bathroom (3 nights, B&B, 3 dinners)480* Student is undergraduate or post-graduate, and rate does not apply to post-docs or students in paid employment/ continued 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 by card online ( HYPERLINK "http://www.maggichurchouseevents.co.uk/bmcs/CMC" www.maggichurchouseevents.co.uk/bmcs/CMC) Yes/NoPlease note that your e-mail address will be included in the List of Participants unless you indicate otherwiseIncludePlease return completed form to Maggi Churchouse, RSC-BMCS Secretariat 3 East Barn, Market Weston Road, Thelnetham, Diss IP22 1JJ, UK Telephone: +44 (0)1359 221004, e-mail:  HYPERLINK "mailto:maggi@maggichurchouseevents.co.uk" maggi@maggichurchouseevents.co.uk Cancellation Policy In the event of cancellation before 24th August, 80% of the fee paid will be refunded. 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