Booking Form

{"elements":[{"isDiscrete":false,"hidden":false,"name":"Name","readOnly":false,"id":651062666,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"Organisation (optional)","readOnly":false,"id":651063016,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"Position within organisation (optional)","readOnly":false,"id":651063747,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"Email ","readOnly":false,"id":651064079,"type":"emailElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"All day","value":"0-allday"},{"text":"Morning only","value":"1-morningonly"},{"text":"Afternoon only","value":"2-afternoononly"}],"name":"I will be attending the conference:","readOnly":false,"id":651065162,"type":"radioElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"I will require lunch","value":"0-iwillrequirelunch"},{"text":"I will not require lunch","value":"1-iwillnotrequirelunch"}],"name":"Lunch requirements:","readOnly":false,"id":651064804,"type":"radioElement"},{"isDiscrete":false,"hidden":false,"name":"I have the following dietary requirements:","readOnly":false,"id":651065065,"type":"textFieldElement"},{"isDiscrete":false,"hidden":false,"name":"I have the following access requirements:","readOnly":false,"id":651065199,"type":"textFieldElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"I wish to apply for a bursary to attend the conference.","value":"0-iwishtoapplyforabursarytoattendtheconference."},{"text":"I do not wish to apply for a bursary to attend the conference","value":"1-idonotwishtoapplyforabursarytoattendtheconference"}],"name":"Limited funding for travel support will be available. Priority will be given to early career researchers or participants who cannot draw upon institutional funding. Please indicate if you wish to apply for a bursary to attend the conference and further information will be provided.","readOnly":false,"id":651065696,"type":"radioElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"Modern Records Centre website / social media","value":"0-modernrecordscentrewebsitesocialmedia"},{"text":"Centre for the History of Medicine Science and Technology website / social media","value":"1-centreforthehistoryofmedicinescienceandtechnologywebsitesocialmedia"}],"name":"Please tell us where you heard about the conference:","readOnly":false,"id":651065786,"type":"radioElement"},{"isDiscrete":true,"hidden":false,"values":[{"text":"I give my permission","value":"0-igivemypermission"},{"text":"I do not give my permission","value":"1-idonotgivemypermission"}],"name":"The Modern Records Centre may like to contact you occasionally about our future events and conferences by email. Please indicate whether you give your permission for us to do this below:","readOnly":false,"id":651065910,"type":"radioElement"}]}