Student Conference 2016 booking form
Saturday 20th February, St Luke’s Church Centre, Birmingham
St Luke’s Church Centre, Great Colmore Street, Lee Bank, Birmingham, B15 2AT
Please complete the form below, Save As ‘[Your Name] booking form’, and email to
Emily@cis.org.uk. If you have signed up as a member of Christians in Science in the last year,
you are entitled to free entry to your first conference. If this is your ‘free conference’, please
indicate so on the form below.
Registration Details
Title
Choose an item.
Full Name
[Full Name]
Email Address
[Email address]
Contact Telephone Number [Telephone number]
University
[University]
Subject
[Subject]
Are you a CiS Member?
Yes ☐
No ☐
If Yes, is this your free
Yes ☐
No ☐
conf.?
Payment Method
Choose an item.
th
If you are booking before 25 January 2016, booking costs £5. If after 23rd January, £10.
Would you like to order a
Yes ☐
No ☐
jacket potato for lunch
(bring an extra £2.50)
Would you like to come out Yes ☐
No ☐
for dinner after the
conference?
If you would like to pay by credit card or bank card (via PayPal), please state so on the form. You will
then be sent a link from our treasurer within a few days to make the payment online.
If you are paying by cheque (made out to Christians in Science), please send it to:
Emily Sturgess
The King’s Centre
Osney Mead
Oxford
OX2 0ES
If you are paying by bank transfer, please label your payment ‘Student Conference’, and send to
account:
Account name: Christians in Science
Bank: Bank of Scotland
Sort code: 12-05-65
Account number: 00182162
Christians in Science Ltd, incorporated in England and Wales. Registered address 4 Sackville Close, Sevenoaks, TN13 3QD.
Company No. 05959444. Registered Charity No. 1121422
Many Thanks,
Emily Sturgess, Development Officer.
Christians in Science Ltd, incorporated in England and Wales. Registered address 4 Sackville Close, Sevenoaks, TN13 3QD.
Company No. 05959444. Registered Charity No. 1121422