Registration

{"elements":[{"isDiscrete":false,"hidden":false,"name":"1712327373540_0.14226229292103998_0.18174665143660929","readOnly":false,"id":601414145,"type":"commentElement"},{"isDiscrete":false,"hidden":false,"name":"1712322594865_0.7144994098514671_0.7127244014186932","readOnly":false,"id":601414146,"type":"commentElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"I confirm that I am NOT a University of Warwick student, PhD student or staff member.","value":"0-iconfirmthatiamnotauniversityofwarwickstudentphdstudentorstaffmember."}],"name":"External Registration","readOnly":false,"id":601414147,"type":"checkboxElement"},{"isDiscrete":false,"hidden":false,"name":"Full Name","readOnly":false,"id":601414148,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"email","readOnly":false,"id":601414149,"type":"emailElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"----","value":"----"},{"text":"£225: Standard academic delegate fee (NO accommodation)","value":"225"},{"text":"£300: Standard academic delegate fee (WITH accommodation)","value":"300"},{"text":"£325: Industry delegate fee (NO accommodation)","value":"325"},{"text":"£400: Industry delegate fee (WITH accommodation)","value":"400"}],"name":"Registration Payment","readOnly":false,"id":601414150,"type":"paymentElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"----","value":"----"},{"text":"Will attend the conference dinner","value":"50"},{"text":"Will NOT attend the conference dinner","value":"0"}],"name":"Conference dinner","readOnly":false,"id":601897261,"type":"paymentElement"},{"isDiscrete":false,"hidden":false,"name":"Dietary Requirements","readOnly":false,"id":601414152,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"Special needs","readOnly":false,"id":601414153,"type":"textFieldElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"I will need on-site parking (complimentary)","value":"0-iwillneedonsiteparkingcomplimentary"}],"name":"On-site parking","readOnly":false,"id":601898820,"type":"checkboxElement"},{"isDiscrete":false,"hidden":false,"name":"1711124625863_0.17757696832910874_0.026145857391756566","readOnly":false,"id":601414154,"type":"commentElement"},{"isDiscrete":false,"hidden":false,"name":"1712326290078_0.3422133658857337_0.4272656344380953","readOnly":false,"id":601414155,"type":"commentElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"I confirm that I have read the above privacy notice for the event and the terms and conditions (T&Cs).","value":"0-iconfirmthatihavereadtheaboveprivacynoticefortheeventandthetermsandconditionstcs."}],"name":"Statement","readOnly":false,"id":601414156,"type":"checkboxElement"}]}

Please give your full name and e-mail address. Select the correct payment category and press "Send Form". You will be then asked to enter your credit/debit card details.

The full registration cost includes accommodation for 2 nights, all meals and refreshments, from Wednesday, 19th of June to Friday, 21st of June. You can opt out of on-site accommodation if you do not need it. If requested, complimentary on-site car parking will be provided.

ATTENTION: If you are a University of Warwick student or staff member, DO NOT fill out this form. Please instead use the other form given here.

I confirm that I am NOT a University of Warwick student, PhD student or staff member.

Full Name

E-mail

Registration More Details

Conference dinner to take place on June 20th (will incur an additional cost of £50)

Total transaction value: 0 GBP

Dietary Requirements

Special Requirements, e.g. accessibility and alike

I will need on-site parking (complimentary)

Refund Policy:

Please review our terms conditions for further details on our cancellation and refund policy relating to the registration type you have made.

Please read the privacy notice for participants at events and privacy notice for campus visitors, as well as the terms and conditions for booking with accommodation or terms and conditions for booking without accommodation (depending on your choice) carefully.

I confirm that I have read the above privacy notice for the event and the terms and conditions (T&Cs).

Privacy notice

For privacy notice, please see link 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.

Spam prevention

Department of Chemistry

Registration

ATTENTION: If you are a University of Warwick student or staff member, DO NOT fill out this form. Please instead use the other form given here.

Failure to load reCAPTCHA