Registration Form: Membrane Proteins: Structure and Function.

Registration From - Please fill in and print off and send to Dr Phil Biggin as addressed below..

Early Bird- Before 31st January 2015

Registration Type:

Please tick the appropriate boxes

Early Bird Non-member Registration	£460
Early Bird MGMS-Member Registration	£430
Early Bird Student Non-member Registration	£300
Early Bird Student Member Registration	£285
No accommodation or dinner - Non-MGMS-Member Registration	£400
No accommodation or dinner MGMS-member Registration	£370
No accommodation or dinner Student Non-MGMS-member Registration	£290
No accommodation or dinner Student MGMS-member Registration	£275

Please note, students should also provide their supervisor's name and e-mail address.

Abstracts for talks/posters

Simply email the title, author list, affiliation and abstract to

Personal Details

Name:

Affiliation:

Address:

Tel:

E-mail:

I would like to be considered for a small (15-20mins) oral presentation

I am a student and wish to be considered for a bursary. I enclose a supporting letter from my supervisor

Special dietary requirements:

Comments/anything else...

If receipt required (by e-mail), please tick [ ]

Please post completed form, with payment to:-

Dr Phil Biggin
Department of Biochemistry
South Parks Road
Oxford
OX1 3QU
UK

Please use the online shop if you wish to pay by credit card.