Please complete a separate form for each participant (photocopy additional forms if
required) and return to:
BSSVD10, 91 Park Lane, Sutton Bonington, Leicestershire. LE12 5NQ
Title
Forename
Surname
Workplace (eg. Hospital
or company)
Department
Are you a BSSVD
Member?
Mailing Address
Y/N
Date of
application
Telephone
Email address (print
please)
Any special dietary
requirements?
Conference Registration fee includes a conference pack, accommodation where purchased as part of the
package, lunch & refreshments. Payments must accompany the form together with a cheque drawn on
any UK Bank in POUNDS STERLING & made payable to BSSVD10.
Alternatively, if you have already registered online you may pay securely via Paypal.
An administration charge of £50 will be made for cancellations made after October 29th 2010.
Please place an ‘X’ next to your preferred option and make a cheque payable to
‘BSSVD10’ for the corresponding amount.
Credit card payment may be made online in the ‘Payment’ section of the event website
‘ www.bssvdevents.co.uk/payment ’
Booking Detail
1:
1a:
2:
2a:
3:
3a:
4:
5:
6:
Single person allocation
Wednesday dinner & Thursday Gala dinner, bed and breakfast
Thursday & Friday conference
Thursday & Friday lunches
BSSVD
Member
& Early
bird
Option
Non
BSSVD
Member
£458
£488
£400
£455
£310
£340
£260
£280
Wednesday dinner, bed and breakfast
Thursday conference
Thursday lunch
£225
£245
Thursday Gala dinner, bed and breakfast
Friday conference
Friday lunch
£225
£245
Thursday conference
Thursday lunch
£110
£120
Friday conference
Friday lunch
£110
£120
Thursday & Friday conference
Thursday & Friday lunch
£200
£210
Double person allocation
Wednesday dinner & Thursday Gala dinner, bed and breakfast
Thursday & Friday conference
Thursday & Friday lunches
Single person allocation
1 night dinner, bed and breakfast
(If Thursday then access to Gala Dinner is included)
Thursday & Friday conference
Thursday & Friday lunches
Double person allocation
1 night dinner, bed and breakfast
(If Thursday then access to Gala Dinner is included)
2 days conference
2 days lunches
7:
Wednesday dinner only
£40
£40
8:
Thursday Gala dinner only
£60
£60
For further information relating to the event, contact the team at:
BSSVD10, 91 Park Lane, Sutton Bonington, Leicestershire LE12 5NQ.
Tel: 01509 6738927 or 07896 803071
Option