PIL Registration Form

Please ensure that you have chosen the correct delegate rate, if you have any queries please contact the conference department on tel: +44 (0)20 7235 4622 or email:

Please note that cancellations received within 48 hours of the event or in the case of non attendance will not be refunded.

Please fill in your details below to register for the Presidents Invitation Lecture and Dinner

Title:*
	(eg Mr, Mrs, Dr etc)

Full Name:*

Company name:*

Job title:

Individual Ticket £75:

Table of 8 £600:

Table of 10 £750:

Corporate Partner free ticket (one per company):

Enter not this field:

Invoice Address:

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Address line 2:*
Address line 3:
Country:*
Post code:*
Telephone number:*
Email address:*

Contact Mailing address (if different):

Address line 1:
Address line 2:
Address line 3:
Post code:
Country:
Telephone number:
Email address:

*Indicates a field you must enter.

When you have completed the form, please click the Send Details button ONCE to send

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RINA, 10 Upper Belgrave Street, London, SW1X 8BQ, UK E-mail:

PIL Registration Form

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