TEST Academy Registration

Title*
Name*
First Last
Date of Birth*
Date Format: DD slash MM slash YYYY
Phone Office*
Phone Mobile*
Email*
Job Title
Employers Name*
Work Address*
Do you have any dietary requirements?*
Register As*
- IMIA Member
- Non IMIA Member
Conference Fee Only (GBP 500)
Price: £ 500.00
Conference Fee Only (GBP 1,000)
Price: £ 1,000.00
Remarks
Please note:
The number of participants is limited. IMIA Members have priority.
***Following receipt and acceptance of your registration you will receive an invoice with the registration fee to be paid.***
IMIA must confirm in writing that this Registration has been accepted.
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Total
£ 0.00