<p> 51st UK Conference on Human Response to Vibration Institute of Naval Medicine, Gosport 14 – 16 September 2016</p><p>Registration form</p><p>Title Choose an item. Initials Click here to enter text. Forename Click here to enter text. Surname Click here to enter text. Organisation Click here to enter text. Address Click here to enter text. Click here to enter text. City Click here to enter text. Postcode Click here to enter text. Country Click here to enter text.</p><p>Telephone Click here to enter text. Date of birth Click here to enter text. Email Click here to enter text. Nationality/ies Click here to enter text.</p><p>I would like to present a paper ☐ Yes ☐ No</p><p>Provisional title(s), if known: Click here to enter text.</p><p>I will require a parking space ☐ Yes ☐ No Car registration Click here to enter text.</p><p>Dietary requirements Click here to enter text. Access requirements Click here to enter text.</p><p>One attendee £290* (VAT exempt)</p><p>Payment method ☐ Bank transfer ☐ Cheque by post (Details overleaf)</p><p>A receipt will be provided upon payment.</p><p>Please also provide me with: ☐ Invoice prior to payment ☐ Letter of invitation</p><p>Please send completed form and payment (if appropriate) to [email protected] or post to: Dr GS Paddan, Institute of Naval Medicine, Crescent Road, Alverstoke, Gosport, Hampshire PO12 2DL, United Kingdom</p><p>Payment Details</p><p>Bank transfer</p><p>Account name: Institute of Naval Medicine Research Fund Bank: Barclays Bank, Fareham</p><p>Sort code: 20-30-89 Account number: 40510475</p><p>IBAN: GB19 BARC 2030 8940 5104 75 BIC: BARCGB5G</p><p>Reference: If possible, please use your initial and surname to help identify your payment</p><p>Funds to be remitted in Pounds Sterling (£).</p><p>Please send notification of payments to [email protected] or your transaction may be difficult to identify in the bank records.</p><p>Cheque or banker’s draft</p><p>Made out to “INM Research Fund” payable in Pounds Sterling (£), and posted posted with this registration form to: Dr GS Paddan, Institute of Naval Medicine, Crescent Road, Alverstoke, Gosport, Hampshire PO12 2DL, United Kingdom</p><p>Bookings cancelled after 13th August 2016 will carry a cancellation charge.</p><p>*£190 fee comprises:  Conference proceedings</p><p> Conference dinner</p><p> Lunch and refreshments on all three days of the conference</p><p> 15 minute slot to present of your paper (if submitted)</p><p> Use of audio visual equipment </p><p>The conference fee does not include accommodation costs – please make your own arrangements if required. </p><p>Details of local hotels will be available at: www.royalnavy.mod.uk/hrv2016</p>