Speakers Registration Form Thank you for being part this year's conference, please complete the below registration form to reserve your place and let us know of your requirements.Registration and other fees are waived, however we ask for you to cover your dinner fees if applicable. These are to be made payable to BIRD to confirm your place, BACS details below. DEADLINE 20TH NOVEMBER 2024 Question Title * 1. Your details: Title First name Surname Role Organisation Email address Contact telephone Any dietary requirements: Any mobility requirements: Question Title * 2. To enable us to apply for accreditation from the Royal College of Physicians, our application requires a short professional biography from all speakers.Please provide this below, it only needs to be a short paragraph or two. Alternatively, please provide a website link: Question Title * 3. Please also provide a photo we can use for our website and/or programme. Alternatively, please provide a website link: PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Please also provide a photo we can use for our website and/or programme. Alternatively, please provide a website link: Question Title * 4. Please confirm your talk title for the final programme: Question Title * 5. Additional extras: Welcome Drinks Reception - Victoria Art Gallery - Wednesday 11th December 2024, 6.00pm - £0.00 Evening Dinner Reception - Guildhall Bath - Thursday 12th December 2024, 6.30pm - £60.00 per person Question Title * 6. Total payment due: Please make payment via BACS. Unfortunately we do not have an online payment system or credit card facilities. if you would prefer an invoice, please email us.Account name: Bath Institute for Rheumatic DiseasesBank: Unity Trust BankAccount no: 20363439Sort code: 60 83 01IBAN number: GB93 NWBK 6002 3571 4180 24SWIFT number: NWBK GB2LReference No: Please use the payment reference: D39 Skin2024 and your surnameForeign Payments - When making foreign payments to BIRD via Unity Trust Bank, the service is provided via NatWest or Western Union. Unity Trust only require the sort code and account number to be quoted when sending your payment with the IBAN & SWIFT numbers given above. Our sort code and account number are not included in our IBAN & SWIFT numbers. We cannot provide an alternative IBAN or SWIFT numbers - further information here ‘Receiving payments’ & ‘Important information about our Foreign services’. If you need any further information from us please don’t hesitate to get in touch. Cancellation Policy: Cancellations received before 1st August 2024 will receive a full refund. Cancellations received before 1st November 2024 will receive a 50% refund for registration fees, unfortunately hotel cancellations cannot be refunded after 1st November 2024. Cancellations received any later will not be eligible for a refund. Done