Booking Form: Fundamental of Data Collection

Name *

First

Last

Company *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

Email *

Delegate Rates – select *

EIS Member £100+VAT
Standard Rate £125+VAT
Student Rate £25+VAT (limited availability)
Personal Membership of EIS £25+VAT
International Membership of EIS £30+VAT

Discount Code – enter below if applicable

Any Special Dietary Requirements?

Would you like to receive future communications from the EIS? We limit the emails we send and will never pass your details to any other organisation. You are able to unsubscribe at any time. Our privacy statement can be viewed on our website. *

Yes
No

Would you like to receive a certificate to confirm you have attended this seminar? *

Yes please
No thank you

Once submitted you will shortly receive an email confirming your delegate place along with an invoice. Payment can be made by bank transfer or credit card. If you have any additional comments these can be noted below.

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