Are you a member of Veterinary Ireland: (Please circle). Yes or No. If Yes, Vet Ireland Membership No: ... Book online a
Complete and return to book VICAS Conference Desk Email:
[email protected] | Fax:+ 353 1 400 3692 Book online at: www.etouches.com/vicas2017 Post to: VICAS, c/o Keynote PCO, Suite 26, 63 Carysfort Avenue, Blackrock, Co Dublin, Ireland
REGISTRATION FORM ATTENDEE DETAILS First Name/Last Name Practice Address County Email Address**: **All booking correspondences will be sent by email to registered delegates
Telephone: Are you a member of Veterinary Ireland: (Please circle)
Yes or No
If Yes, Vet Ireland Membership No:
Dietary Requirements: (Please advise)
REGISTRATION FEES VICAS CONFERENCE (Friday-Sunday)
Early Bird Fees (Until 13th January 2016)
Late Fees (Booked after 14th January)
Veterinary Ireland Member
€280.00
€315.00
Non-Member
€560.00
€595.00
Graduate Member (from 2014 – 2016)
€140.00
€165.00
IVNA Member
€95.00
€120.00
IVNA Non-Member
€110.00
€135.00
NURSING STREAM – Saturday 4th February
CONFERENCE DINNER Please indicate your attendance below, places are limited €55.00
Friday Conference Dinner
Number of tickets ____
HOTEL ACCOMMODATION Rates are inclusive of Breakfast and all charges. There is limited availability Room Type
Single B&B €89.00
Double / Twin Room B&B €109.00
Check In:
Checkout:
No of Nights €
Total Payment Due:
PAYMENT OPTIONS: Credit Card Payment:
[ ] VISA
[ ] Mastercard
Credit card Number Expiry of Card
__ / __ (MM/YY)
Cheque Payment:
[ ]
CSV
___
Signature:
I have enclosed a cheque made payable to Keynote PCO Ref VICAS
Cancellation & Booking Terms Policy Cancellations and or changes must be sent in writing to the registration desk at
[email protected] and will not be accepted by telephone. There is no refund for non-attendance. Cancellation of a booked item refers to complete/part cancellation and or adjustment/cancellation of accommodation dates or social event tickets based on the specifics to follow: Registration/Event Attendance Cancellation Policy: Before 15th January 2017 – 50% refund | After 15th January 2017 – non-refundable Accommodation Cancellation Policy: A credit card is required as guarantee for all hotel bookings and payment is required in advance. Before 31st December 2016 = Accommodation cancellations will be accepted in full | After 1st January 2017 = No refund. Should you not be able to attend the conference, you can have a colleague take your paid registration. This must be advised to the registration desk in advance for badging purposes (a minimum notice of 2 weeks before the conference). Should you have booked a members rate and your colleague is a NonMember, the supplement will apply. Membership Fees refer to current valid memberships of: Veterinary Ireland / IVNA/ BEVA / AVSPNI / VetNI. Where living and or working in the Republic of Ireland, you must be a member of Veterinary Ireland to avail of the members rate. For other affiliated members societies fees, you must be resident and working outside the Republic of Ireland. Book online at: www.etouches.com/vicas2017
