Registration Form Third biennial conference of the Society for the Philosophy of Science in Practice June 22-24, 2011 (Wednesday to Friday) Held at the University of Exeter and hosted by ESRC Centre for Genomics in Society (Egenis) Program information: http://www.genomicsnetwork.ac.uk/egenis/events/societyforthephilosophyofscienceinpractice-conference/ Title First Name Last Name Institution: Preferred mailing address: City: County/Province/State: Country: Zip/Postal Code: Telephone with area code: Fax: Email: Are you a speaker? Yes No CONFERENCE FEES Registration Fees (All amounts are listed in pounds sterling) Includes the conference dinner, three lunches, refreshments at breaktimes and conference booklet. PLEASE SELECT APPROPRIATE REGISTRAION FEE: Regular registration fee (After 1st May, 2011) Student registration fee Meals: Vegetarian POSTMARKED & PAID £200 £150 Non-vegetarian Other dietary requirements (gluten free etc.) Please state: On campus accommodation We are able to book accommodation at Holland Hall, University of Exeter, Streatham Campus Bookings are for the nights of 21st -23rd June 2011 inclusive (three nights). All bedrooms have double beds with ensuite facilities and breakfast is included in the price. Ensuite accommodation: single occupancy (nights of 21st -23rd June inclusive) Ensuite accommodation: double occupancy (nights of 21st -23rd June inclusive) Name of accompanying guest: TOTAL AMOUNT OF PAYMENT DUE (in GB£): PRICE £105 £157.50 Accessibility Please list any special requirements you have which will make the conference more accessible for you. Payment PAYMENT METHOD Please check appropriate box: Cheque VISA MasterCard Debit card Cheques must be in £ Pounds Sterling made payable to: University of Exeter If paying by credit/debit card, please complete the credit/debit authorisation form on the next page Please send completed registration form with payment to: 3rd biennial conference of the SPSP University of Exeter Byrne House St German’s Road Exeter, Devon EX4 4PJ United Kingdom Phone: +44 (0)1392 725 140 FAX: +44 (0)1392 724 676 Email: egenis@exeter.ac.uk Sending card payments by fax, e-mail or telephone cannot be deemed 100% secure due to the security weakness inherent in the global IT networks. You should be advised that if you do, you do so at your own risk, so please take care to protect your financial information. Cancellations/Changes and Refunds: Please see the full Terms and Conditions on 3rd Biennial Conference of the SPSP website http://www.genomicsnetwork.ac.uk/egenis/events/societyforthephilosophyofscienceinpractice-conference • A full refund of the conference booking will be made if notification of cancellation is received more than 9 weeks prior to the conference. • A 25% deduction will be made if notification of cancellation is received between 9 and 5 weeks prior to the conference. • A 50% deduction will be made if notification of cancellation is received between 5 and 4 weeks prior to the conference. • No refund of the conference booking will be made if notification of cancellation is made less than 4 weeks prior to the conference. Egenis – The ESRC Centre for Genomics in Society University of Exeter Byrne House St German’s Road Exeter, Devon EX4 4PJ Telephone +44 (0) 1392 725 140 Fax +44 (0) 1392 724 676 Email: egenis@exeter.ac.uk Web: http://www.genomicsnetwork.ac.uk/egenis/ DETAILS OF PAYMENT: Registration for 3rd Biennial Conference of the SPSP DELEGATE NAME: FOR OFFICE USE ONLY 1 U U U J J 4 1 Z - S X 0 1 U J 8 L 0 0 0 CREDIT/ DEBIT CARD AUTHORISATION Card Holders Name Signature ________________________ Credit Card Debit Card Card Number Start Date Expiry Date Debit Card Issue No. (If applicable) Security Number (last 3 digits of number on signature strip) Cardholder’s address (including Postcode) Cardholder's telephone no. Amount authorised to be paid using the above card details: Total (GB£) £ p We do not recommend returning this form by fax or e-mail, since these methods cannot be deemed 100% secure due to the security weakness inherent in global IT networks. Be advised that if you do so, it is at your own risk. Name: Amount: