Register to Attend - 8th May 2019

Full name

Organisation:

Job title:

Contact Number:

Address line 1

Address line 2

Town or city

County

Postcode

Country

Payment Options:

Cancellation policy: https://warwick.ac.uk/fac/sci/med/study/cpd/cancellation/

Details for Invoicing

If you have selected 'Pay by Invoice' above, please provide the details requested below. Invoices will be raised and sent directly to customers based on this information.

Company name:

Invoice Address:

Finance email:

Telephone number:

For the attention of:
(Person and/or department)

Customer order number:
(if it needs to be quoted on the invoice)

Data Protection

I understand that:

I understand that: The University of Warwick will use your personal data, including without limitation, name, address(es), email address, contact numbers, age, gender, date of birth, department, year of study, student status, type of course, department and details of my progress on my course (Personal Information) for the purpose(s) outlined in this notice and the University’s Data Protection Guidelines: http://www2.warwick.ac.uk/services/vco/exec/registrar/legalservices/dataprotection Your personal data will not be shared or disclosed to any third parties external to the University of Warwick except the Association for Infant Mental Health (AIMH UK) who will use your personal data for the purpose(s) of issuing Continuing Professional Development credits on completion of the course. By submitting this questionnaire you agree to your personal data being processed and used by the University of Warwick and AIMH UK for the purposes outlined above and that the data will be held in perpetuity to maintain the integrity of The University’s Student and Academic Records. For further information regarding: how your information is held, including how we maintain the security of your information, your rights to access information we hold about you, how to update us on any changes to your details or to withdraw your consent for your data to be used for the purposes outlines above then please contact: pgt-portfolio3@warwick.ac.uk

Declaration

By ticking the box below I confirm that I have read and understood the Data Protection Notice and agree for the University to use my personal data as specified.

I agree

Payment

I agree

I have selected to pay by invoice

Privacy notice

This form will be used to manage attendance at a course. Your attendance at the course 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 course.

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 Medical School