Registration Form

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Please complete this form in full and then click on the blue button at the bottom of the page to pay your £10 registration fee. Your registration will not be complete until you have paid your conference fee. If you know the details of the two guests you want to invite to the conference please include thier details below (you will have a further chance to register guests if you have not yet decided who you would like to invite):

Title

Surname

First name

Institution/organisation

Department

Course

Address

Telephone

E-mail

Yes

No

Yes

No

If yes, please complete the following 3 boxes as appropriate:

Abstract Title

Abstract (250 words max)

Please include references of around 5 pieces of academic work relevant to your presentation

Please outline any special dietary requirements:

Please indicate any access / disability requirements:

Guest 1 details:

Title

Surname

First name

Email

Guest 2 details:

Title

Surname

First name

Email

I agree to my name, affiliation and email address being included on the attendance list distributed to all delegates at this event.

I would like to receive information about future IATL events/initiatives.

Please note that this event may be recorded in a variety of ways (e.g. video, still images, audio), with the resulting media subsequently used in such ways as the Institute for Advanced Teaching and Learning sees fit. If you would prefer not to be recorded, please make yourself known to the organisers on the day.

Privacy notice

This form will be used to manage your attendance at the Monash-Warwick International Conference of Undergraduate Research 2013. Your attendance at the event will be recorded and associated with your name, but no other personally identifiable data will be stored and your data will not be used for any purpose other than as a record of the event, unless you have given your permission above.

The University of Warwick is the Data Controller of any information you have entered on this form and is committed to protecting the rights of individuals in line with Data Protection Legislation. The University's Data Protection webpages provide further information on your rights and how the University processes personal data. If you wish to submit a data subjects rights request, make a complaint or report a suspected personal data breach, please contact the University’s Data Protection Officer by email at infocompliance@warwick.ac.uk.

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