Other payment type

{"elements":[{"isDiscrete":false,"hidden":false,"name":"Last name","readOnly":false,"id":498734887,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"First name","readOnly":false,"id":498734888,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"email","readOnly":false,"id":498734889,"type":"textFieldElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"Pay by invoice","value":"0-paybyinvoice"},{"text":"Pay by bank transfer (no invoice)","value":"1-paybybanktransfernoinvoice"},{"text":"Warwick staff/ student internal transfer","value":"2-warwickstaffstudentinternaltransfer"}],"name":"Payment type","readOnly":false,"id":498734890,"type":"listElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"Full Registration with ensuite £650","value":"0-fullregistrationwithensuite650"},{"text":"Full Registration non ensuite £550","value":"1-fullregistrationnonensuite550"},{"text":"Student Registration £350","value":"2-studentregistration350"},{"text":"Full Registration with ensuite PLUS 1 extra ensuite night £750","value":"3-fullregistrationwithensuiteplus1extraensuitenight750"},{"text":"Full Registration with ensuite PLUS 2 extra ensuite nights £850","value":"4-fullregistrationwithensuiteplus2extraensuitenights850"},{"text":"Full Registration non ensuite PLUS 1 extra non ensuite night £630","value":"5-fullregistrationnonensuiteplus1extranonensuitenight630"},{"text":"Full Registration non ensuite PLUS 2 extra non ensuite nights £710","value":"6-fullregistrationnonensuiteplus2extranonensuitenights710"},{"text":"Student Registration PLUS 1 extra non ensuite night £430","value":"7-studentregistrationplus1extranonensuitenight430"},{"text":"Student Registration PLUS 2 extra non ensuite nights £510","value":"8-studentregistrationplus2extranonensuitenights510"},{"text":"1 additional night ensuite £80","value":"9-1additionalnightensuite80"},{"text":"2 additional nights £160","value":"10-2additionalnights160"}],"name":"Payment amount","readOnly":false,"id":498734891,"type":"listElement"},{"isDiscrete":false,"hidden":false,"name":"Invoice address (if applicable)","readOnly":false,"id":498734892,"type":"textBoxElement"},{"isDiscrete":false,"hidden":false,"name":"Other notes/ comments (e.g. Warwick participants may like to add a cost code)","readOnly":false,"id":498734893,"type":"textBoxElement"},{"isDiscrete":false,"hidden":false,"name":"1564744536366_0.32008418615794054_0.07366221442222276","readOnly":false,"id":498734894,"type":"commentElement"},{"isDiscrete":false,"hidden":false,"name":"1564744536367_0.9737121193765003_0.076973652314274","readOnly":false,"id":498734895,"type":"commentElement"}]}

Last name

First name

Payment type

Payment amount

Invoice address (if applicable)

Other notes/ comments (e.g. Warwick participants may like to add a cost code)

Please note that invoices and bank transfers are not being administrated through the University of Warwick.

For bank transfers use the following bank account details Name: Warwick Polymers 02 Note 02 is important IBAN GB71MIDL40181742703416 BIC MIDLGB2103V Acct # 42703416 Sort Code 40 18 17

Privacy notice

This form will be used to manage attendance at an event. Your attendance at the event will be recorded and associated with your name, but no other personally identifiable data will be stored, and the data will not be used for any purpose other than as a record of the event.

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.

Spam prevention

Warwick Polymer Conference 2020

Other payment type

Failure to load reCAPTCHA