Registration Form Spring Meeting 2015

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FACULTY OF RADIOLOGISTS
Combined Spring Meeting
24th & 25th April 2015
Maryborough House, Cork
Registration Category:
Early Fee
Late Fee
(On or before 10th April 2015)
(After 10th April 2015)
Consultants
€150
€175
Retired Consultants
Radiographers
Physicists
Registrars in Training
NCHDs
(First authors of accepted posters are waived)
€75
€100
Lunch will be provided on the Friday for all registrants
Name ____________________________________Category_______________________________
Contact Address
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Email:
__________________________________________________________________________
Registration Fee Enclosed
______________________________________ Euro
Conference Dinner on Friday 24th April, Maryborough House
€70 per person
I wish to attend the Dinner
Yes
I wish to bring a guest
Yes
Name of guest
__________________________________________
Total (Registration & Dinner) Enclosed ____________________________ Euro
Faculty of Radiologists, Royal College of Surgeons in Ireland
123 St. Stephen’s Green, Dublin 2.
Tel: +353-1-402 2139 Fax: +353-1-402 2466
Email: radiologyscientific@rcsi.ie
Website: www.radiology.ie
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FACULTY OF RADIOLOGISTS
Combined Spring Meeting
24th & 25th April 2015
Maryborough House, Cork
Registration policy
Numbers for the meeting will be limited and we cannot guarantee places will be available on the day so
we recommend you register in advance. Please note that payment must be made at time of registration,
and we cannot hold places.
Cancellation Policy
A full refund will be available for cancellations up to and including the 10th of April. Cancellations made up
to and including the 20th of April will be entitled to a 50% refund. For cancellations after that date, we
regret that we will not be able to offer a refund.
Accommodation
Please note that all accommodation enquiries must be directed to the hotel. We have rooms held at
Maryborough House for the Thursday and Friday night at the following b & b rates per night:
€105.00 per person, Bed & Breakfast, based on single occupancy.
€140.00 per twin/double room, Bed & Breakfast
Please note that the booking must be made directly with Maryborough House, and to avail of this
negotiated rate, please provide the booking office with the name of the conference. Rooms will be held
until 23rd March 2015.
Contact details:
T: +353 21 436 5555 / F: +353 21 436 5662 / E: info@maryborough.ie
Faculty of Radiologists, Royal College of Surgeons in Ireland
123 St. Stephen’s Green, Dublin 2.
Tel: +353-1-402 2139 Fax: +353-1-402 2466
Email: radiologyscientific@rcsi.ie
Website: www.radiology.ie
FACULTY OF RADIOLOGISTS
Combined Spring Meeting
24th & 25th April 2015
Maryborough House, Cork
Payment Form
Please make cheques payable to the Faculty of Radiologists, or alternatively you can pay by credit
card or laser.
Mastercard:
Visa:
Laser:
Card Number:
______________________________________________________
Expiry Date:
______________________________________________________
Name (block letters):
______________________________________________________
Address:
______________________________________________________
Cheque:
______________________________________________________
______________________________________________________
Signature:
_______________________________
Date: __________________
Faculty of Radiologists, Royal College of Surgeons in Ireland
123 St. Stephen’s Green, Dublin 2.
Tel: +353-1-402 2139 Fax: +353-1-402 2466
Email: radiologyscientific@rcsi.ie
Website: www.radiology.ie
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