Credit Card Registration

Please avoid using accented characters or any symbols throughout this form. You can email deborah@constableandsmith.com to have an accent added to your name for your badge.

Title *

First Name *

Surname (family name) *

Organisation/Institution/Company *

Postal address for receipt *

Address continued *

City/Town *

Postcode *

Country *

Delegate Email Address *

2nd email address (if required) for a copy of receipt

Telephone

Dietary Requirements

Please give details of any special requirements and/or disabilities/medical conditions etc

Further Information

Fees *

Fees include refreshments, lunches, poster & exhibition receptions and the conference dinner

Members rate applies to members of CSP or IchemE members

**EARLY BIRD DEADLINE 29 May 2023 after which a late fee is applied**

CSP or IchemE Membership No. (if applicable)

Social Events

Please indicate if you plan to attend these events.

They are included in the registration fee no additional fee is required it helps us with planning dietary requirements and providing guest names to the venue.

Conference dinner *

YES I will attend the Conference Dinner Wednesday 23 August 2023 at Leeds Castle NO I will not attend the Conference Dinner Wednesday 23 August 2023 at Leeds Castle

List of Participants. We will be creating a delegate list to be published for distribution at the conference to delegates, exhibitors and sponsors. The list will include name and email address. Can we add you to this list? *

Yes please include me on the list of participants No please do not include me on the list of participants

Data Protection: we would like to use the personal information included on this form to send details of similar meetings or other services. Please tick the following box if you are happy to receive these updates.
You can opt out at any point

Mailing lists *

Please add me to the mailing list Please keep me on the mailing list Please do not include me on the mailing list

If you get an error and the form doesn't process. Please check you haven't entered any accented characters or any symbols throughout this form. Unfortunately the form can't recognise these

Please only complete the form once. Any problems please email deborah@constableandsmith.com