Name*

Mobile Contact Number

Please select the requirements for your conference attendance*
Accommodation on Monday 8th DecemberConference Pass on Tuesday 9th DecemberAttendance at the Gala Dinner on Tuesday 9th DecemberAccommodation on Tuesday 9th DecemberConference Pass on Wednesday 10th December

Do you have any special / dietary requirements?

How will you be travelling to the conference?

Estimated date / time of arrival at the hotel?

If you wish to receive CPD credits, please select the appropriate option below.
IBMSRCPathOther

If Other, a general certificate of attendance will be issued.

Please could you provide a brief profile / bio about yourself. (Approx. 100 words)

Please could you provide a picture of yourself for use on the programme and website:

Please leave this field empty.

*required