Registration form for NET2011
Complete the form below to register for NET2011. Please complete and submit a separate form for each person registering.
Once you have submitted your completed form you will receive an immediate email acknowledgement of your online registration. This will be followed by confirmation of your registration details within 5 working days. If you have not heard from us within this time please contact us again.
Delegate details
* - Required fields
Title *
Mr
Mrs
Miss
Ms
Dr
Professor
Other - Pls Specify Specify:
First name *
Family name *
Job title *
Department
Institution/Organisation/Company *
Address 1
Address 2
Address 3
City *
County
Postcode *
Country *
United Kingdom
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegowina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, the Democratic Republic of the
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia (Hrvatska)
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
France, Metropolitan
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and Mc Donald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia, The Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Northen Ireland
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Kitts and Nevis
Saint LUCIA
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia (Slovak Republic)
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Pierre and Miquelon
Sudan
Suriname
Svalbard and Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province of China
Tajikistan
Tanzania, United Republic of
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna Islands
Western Sahara
Yemen
Yugoslavia
Zambia
Zimbabwe
Telephone *
Email Address *
Please tick if you do not want your email address to appear in the delegate list.
Please indicate your role/s at the conference:
Core Presenter
Theme Presenter
Symposium Presenter
Poster presenter
Convenor
Delegate
Dietary preference:
Do you have any other particular requirements?
e.g. hearing difficulty, mobility disability, etc.
Please specify:
Where did you first hear about this conference?:
Conference fees
Whole conference attendance – non-residential
(for accommodation, see below)
Tuesday 6 September to lunchtime on Thursday 8 September 2011
Fee covers: full conference registration, delegate pack including copies of core papers and keynote papers, all lunches and refreshments from morning coffee on Tuesday to lunch on Thursday.
Early bird discount currently applies .
For bookings made before 8 July 2011
£397.00 (+ VAT £79.40)
For bookings made after 8 July 2011
£437.00 (+ VAT £87.40)
Attendance at one theme only – non-residential
(for accommodation, see below)
Tuesday 6 September to lunchtime on Wednesday 7 September 2011
Fee covers: conference registration for one theme session, delegate pack including copies of core papers and keynote papers, lunches and refreshments. Early bird discount currently applies .
For bookings made before 8 July 2011
£374.00 (+ VAT £74.80)
For bookings made after 8 July 2011
£414.00 (+ VAT £82.80)
Attendance at one theme only – non-residential.
(for accommodation, see below)
Wednesday 7 September to lunchtime on Thursday 8 September 2011
Fee covers: conference registration for one theme session, delegate pack including copies of core papers and keynote papers, lunches and refreshments.
Early bird discount currently applies .
For bookings made before 8 July 2011
£374.00 (+ VAT £74.80)
For bookings made after 8 July 2011
£414.00 (+ VAT £82.80)
Accommodation situated at Churchill College and Murray Edwards College
Accommodation on Monday 5 September
Includes bed, breakfast and evening meal
£80.95 (+ VAT £16.19)
Accommodation on Tuesday 6 September
Includes bed, breakfast and evening meal
£80.95 (+ VAT £16.19)
Accommodation on Wednesday 7 September
Includes bed, breakfast* Please note: you will need to make your own arrangements for dinner on Wednesday if you choose not to attend the Gala Conference Dinner.
£63.95 (+ VAT £ 12.79)
Accommodation on Thursday 8 September
Includes bed, breakfast and evening meal
£80.95 (+ VAT £16.19)
Gala Conference Dinner on Wednesday 7 September
Includes sparkling drinks reception, dinner at Girton College, followed by entertainment and disco
£41.00 (+ VAT £8.20)
Practical workshop: Working towards publication
14.00-16.00 Monday 5 September, 15.00-17.00 Thursday 8 and 09.00-13.00 Friday 9 September. Includes background papers, refreshments each day and a lunch on Friday 9 September
£150.00 (+ VAT £30.00)
Conference papers only
I cannot attend the conference but would like to purchase a copy of the conference papers
£100.00 (+ VAT £20.00)
Workshops and tour
The publishing process and recent trends in publishing
Monday 5 September between 20.00–21.30 hours
I wish to attend
Special interest group: student retention in healthcare programmes
Tuesday 6 September between 20.00–21.30 hours
I wish to attend
Complimentary tour of Cambridge
Wednesday 7 September at 16.00 hours
(Places are limited and will be allocated in the order in which registrations are received.)
I wish to attend
Payment Information
All participants, including those from overseas, must pay the costs in British pounds sterling.
Payment may be made by cheque, international transfer, BACS, credit card or invoice.
A VAT invoice will be issued on registration. VAT reg no. 572 9262 18
Please indicate how you wish to pay
I wish to pay by cheque .
I will forward the cheque to you together with a printed copy of my email registration form acknowledgement.
Please make cheques payable to Jill Rogers Associates Ltd and send it to: NET2011, 6 The Maltings, Millfield, Cottenham, Cambridge, CB24 8RE, UK.
For International transfers or BACS payments please pay into:
Account name: Jill Rogers Associates Ltd
Bank: Royal Bank of Scotland
Account no: 22024144
Sort code: 16-15-19
IBAN code: GB30RBOS16151922024144
Swift/BIC code: RBOSGB2L
I wish to pay by credit card.
Please note: Once you have submitted your registration you will receive an automated acknowledgement email, followed within 5 working days, by a confirmation email from the NET conference office. This confirmation email will show you the amount due and have a link to our PayPal page. There will be a small charge for paying by credit card.
I wish to be invoiced.
Please complete the invoice form below. To save time, you can click the checkbox to copy your details if they are the same as your registration details.