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 PLEASE NOTE: CREDIT CARDS CANNOT BE PROCESSED IN DOLLARS OR EUROS BECAUSE PHACILITATE IS A UK COMPANY. IF YOU WISH TO PAY YOUR REGISTRATION FEE BY AMEX, MASTERCARD OR VISA YOUR CARD WILL BE CHARGED AT THE STERLING RATE STATED BELOW. YOUR CARD ISSUER WILL THEN CONVERT THIS STERLING AMOUNT INTO YOUR LOCAL CURRENCY AT TODAY’S PREVAILING RATE. THE AMOUNT THAT APPEARS ON YOUR STATEMENT MAY NOT, THEREFORE, MATCH OUR PUBLISHED EURO OR DOLLAR RATES.

IF YOU WISH TO PAY IN DOLLARS OR EUROS AT OUR PUBLISHED RATES, PLEASE EITHER SEND A BANK TRANSFER OR A CHEQUE ON RECEIPT OF OUR INVOICE.
 
Phacilitate Registration Form - Phacilitate Leaders' Forum 2010 - All 3 days - Academic Rate
Fields in bold are mandatory
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Online credit card payment must be in £ Sterling.
  £ Sterling US Dollars  
All 3 days - Academic Rate 965 1,495
Name
Title First Name Last Name
Job Title
Organisation
Email Address
Telephone
Fax
Address
City/Town
State/Prov/County
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Assistant's Name
Assistant's E-mail
Approving Manager
Does your Approving Manager work in the same location as you (if applicable)?
If "no", at which site are they located?
Where did you hear about this event?
I am claiming the 25% Group Booking Discount for groups of 4 or more. The other members of my group are:
I am claiming a discount by courtesy of:
Name of Exhibitor:
Payment Method
Online Credit Card authorisation (Sterling only)
Transactions take place at the Secure Checkout
Fax this Credit Card Authorisation form to us at +44 (0) 20 7839 6533
Invoice for payment by bank transfer or by cheque drawn on a UK bank, within 30 days and before the event
Upon receipt of your payment, we will send you your username and password for the Delegate Zone, which will be available from six weeks before the event.
Additional Information:
 
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