Test event registration

Delegate details

Name*

Title First Last

Organisation currently employed at / retired from*

Specialty and job title*

Work Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

I am currently working in one of the countries classified by the World Bank as low or low to middle income country*

Yes
No

If you are currently working in one of the countries classified by the World Bank as low or low to middle income country’. Select your country in one of the options below

Choose country

Email*

Please provide your preferred email address as the confirmation of your registration will be sent to this email address

Phone

Special dietary requirements, if any

Registration details

Cancellation policy: up to 30th August 2022 full refund minus £20 admin charge. After that, no refund is possible

		15th August 2022 onwards
		One day	Both days
Consultants / Specialty, MTI, Staff Grade and SAS Doctors	Virtual	N/A*	70
Consultants / Specialty, MTI, Staff Grade and SAS Doctors	In person#	£190	£270
Trainee & Retired Doctors / Nurses / AHPs / ACPs / ODPs	Virtual	N/A*	£50
Trainee & Retired Doctors / Nurses / AHPs / ACPs / ODPs	In person#	£100	£160
Foundation Year Doctors / Medical Students / Doctors in L-I & L-MI Countries**	Virtual	N/A*	£20
	In person#	£70	£110

* One day registration is not available for delegates attending virtually

# Delegates would attend conference in person in Nottingham UK, subject to government guidelines at the time. If they aren’t allowed to, due to COVID-19 restrictions, the difference between in-person fees and virtual fees would be refunded.

**Doctors currently working in Low-income (L-I) and Low-er-middle income (L-MI) countries (According to World Bank) eligible for reduced delegate fees for the confer-ence. List of countries: https://datahelpdesk.worldbank.

Select ticket type*

Coupon

Which day(s) are you attending*

Where did you hear about us?

Membership level*

9th EMCC & POM Conference Member’s Area

You will be automatically added to the website with a membership level for the conference so you can download and view speakers slides etc ..

Total

£ 0.00

Method of payment*

Credit Card or PayPal (supports credit cards without paypal account)

Use of your data:

We’d like to contact you by email to keep you aware of what we’re up to and to help you find our conferences.

Please let us know your preference by selecting an option

Yes, please keep me informed about events from the Midlands Medical Conferences
No thank you, I do not wish to be contacted about other events

You can choose to stop receiving these communications at any time by emailing info@midlandsmedicalconferences.org Communications relating to your booking and the conference you have registered for are an exception to this.

Midlands Medical Conferences is committed to handling your personal details with care, please see our privacy policy here. Sometimes it is necessary to share information with third parties as an essential part of being able to provide our services to you. By completing your registration, you agree that we can share your details as follows:

Name and dietary/access requirements: will be shared with our venue and/or caterer
Name and email address: will be shared with AV partners, who we have a data sharing agreement with, where it is necessary to set up delegate access to an online event platform

Method of Payment:

Please pay online: Account Name: Midlands Medical Conferences

Account Number: 05051835

Sort Code: 40-35-18

Please write your name as the reference for your payment

For further information please email at: info@midlandsmedicalconferences.org

Test 9th East Midlands Critical Care & Peri-Operative Medicine Conference

Delegate details

Registration details

Use of your data:

Method of Payment: