Personalised Medicine in Healthcare

Manchester International Convention Centre
Monday 4 - Wednesday 6 September 2006

Accommodation Booking Form
Note: If you have already booked accommodation for this event and have any queries or would like to make an amendment, please do not use this form, but contact:

Pat Neill
Procon Conferences Ltd
Tattersall House
East Parade
Harrogate
HG1 5LT
Tel: +44 (0) 1423 564488
Fax: +44 (0) 1423 701433
Email: patn@procon-conferences.co.uk
PLEASE READ THE TERMS AND CONDITIONS VERY CAREFULLY BEFORE MAKING YOUR BOOKING

Please complete your details below. All fields marked with an asterisk * are compulsory
  

I have read and I accept the Terms and Conditions*
Your Information:
Title:* First Name*: Initial(s):* Family Name:*
              
Address for correspondence:*
Is this your home or work address?*
If work, please include your company/institution and department name below:
Company/Institution: 
Position: 
Address*: 
City/Town*: 
State/Province/County: 
Post/Zip Code*: 
Country*: 
Telephone*: 
Int’l Code Area Code: Number:
  
Mobile: 
Fax: 
E-Mail*: 
Accommodation Required:
Please complete the details below, indicating your preference from the list of hotels. If none of your preferred hotels are available, a reservation will be made at an alternative hotel of a similar standard. Likewise, if single rooms are not available, you will be booked a twin/double for single occupancy at the rates stated.
Hotel List
1st Choice HOTEL*: 
2nd Choice HOTEL*: 
3rd Choice HOTEL*: 
Please select the room type required*:
Single Bedded Room    Twin    Double

Arrival Date*:  - -
Departure Date*:  - -
Number of Nights*: 
Number of Residents in room*: 
 
Name(s) of Residents*: 
Special Requirements (e.g. wheelchair access, non-smoking, dietary requirements, etc.)
GUARANTEE OF BOOKING

Please check the details you have entered. When they are correct, press Continue. You will be asked to check your entries before giving your credit card details. The credit card details are required to guarantee your booking. No charge will be made to this card unless you fail to arrive at your hotel and have not cancelled your booking in writing with Procon Conferences.

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